Sesso maschile

Sesso, in aumento le ricostruzioni dell'organo maschile

ROMA - Sesso maschile, sono in aumento in Italia le ricostruzioni chirurgiche dell'organo e dei genitali esterni: sia quelle legate ad un intervento per la presenza di malformazioni che per una malattia.

«Un incremento - spiega Andrea Tasca, direttore dell'unità operativa di Urologia dell'ospedale San Bortolo di Vicenza al congresso della Società italiana di urologia a Firenze- dovuto soprattutto alla maggiore capacità di intercettare i casi.

Parliamo anche di tumore che può essere affrontato con il bisturi e ricostruito. Ma la conoscenza della prevenzione è ancora bassa». Un maschio su tre apprende le proprie conoscenze sulla disfunzione erettile dalla tv, giornali o internet, contro il 12% dei pazienti colpiti da ipertrofia prostatica che più spesso chiedono al medico o al farmacista. In entrambi i casi c'è un 10% di pazienti che non sa che oggi esistono terapie semplici e molto efficaci per la proroa malattia.

E' quanto emerge dall'indagine condotta dal nuovo Osservatorio pianeta uomo promosso dalla Società italiana di urologia su 1000 over 40 per studiare l'impatto della disfunzione erettile e dell'ipertrofia prostatica benigna sulla qualità della vita. La ricerca presentata a Firenze dimostra «come sia indispensabile - avverte Vincenzo Mirone, segretario generale della Siu - che questi argomenti vengano discussi in modo da fugare paure e dubbi, così da restituire la serenità all'uomo. E' importante perciò che lo specialista diventi il tutor del paziente. Infatti, se i pazienti vengono seguiti e sostenuti dal medico, sono soddisfatti dell cure e non le abbandonano».

FONTE: http://www.leggo.it/SOCIETA/SANITA/sesso_o...ie/925471.shtml

Circoncisione e allattamento

Circumcision and Breastfeeding Studies

Over the years, many studies have established a link between infant circumcision and difficulty breastfeeding. Here is a summary of a dozen related medical studies and literature:

Breastfeeding Answers Made Simple: A Guide for Helping Mothers
The pain of circumcision causes breastfeeding problems in some babies. After this procedure, a baby may have trouble settling in at the breast, may refuse the breast, or may shut down and be unresponsive.
Mohrbacher, Nancy. Breastfeeding Answers Made Simple: A Guide for Helping Mothers. Plano: Hale, 2010.

The Breastfeeding Answer Book
When a baby undergoes a painful medical procedure, such as a heel stick, injection, spinal tap, or circumcision, he may shut down and be unreceptive to feedings until he is feeling better.
Mohrbacher N, Stock J. The Breastfeeding Answer Book. Schaumburg: La Leche League International, 2003.

Breastfeeding Problems After Circumcision
Unquestionably, many babies are circumcised and go on to breastfeed without difficulty. But for some, the pain after circumcision may cause just enough disruption to interfere with the breastfeeding relationship.
[Breastfeeding problems after circumcision]. Leaven, September-October 1994:78.

Circumcision and Breastfeeding
Boys who are circumcised before breastfeeding has been established have more problems with breastfeeding. Conversely, boys who are recovering from a traumatic birth but are left intact have fewer breastfeeding difficulties.
Lee N. Circumcision and Breastfeeding. [Letter] J Hum Lact 2000;16(4):295.

The Case Against Circumcision
The radical practice of routinely circumcising babies did not begin until the Cold War era. This institutionalization of what amounted to compulsory circumcision was part of the same movement that pathologized and medicalized birth and actively discouraged breastfeeding.
Fleiss P. 1997. The case against circumcision. Mothering Magazine Winter 1997:36-45.

Breastfeeding Must Be Given Priority Over Circumcision
Prospective parents should be warned in advance of circumcision’s interference with breastfeeding. While current informed medical opinion does not support the practice, some parents, however, still have their baby circumcised. In this case, the circumcision should be avoided at least until breastfeeding is well established. Such a recommendation should be a part of all printed material regarding breastfeeding that is provided to expectant mothers in advance of delivery and should be volunteered by lactation consultants in every pre-partum counseling session.
Hill G. Breastfeeding must be given priority over circumcision. J Hum Lact 2003;19(1):21.

Acetaminophen Analgesia in Neonatal Circumcision: The Effect on Pain
Preoperatively, all neonates fed well. Neonate feeding behavior after circumcision deteriorated in neonates in both groups. Of those breastfed, 2 of 11 (18%) in the acetaminophen group and 3 of 8 (37%) in the placebo group either were judged to have breast-fed poorly or required formula feedings after circumcision. Of neonates who were formula-fed, 4 of 12 (33%) in the acetaminophen group and 2 of 13 (15%) in the placebo group fed poorly after circumcision. Acetaminophen did not significantly influence feeding changes for either breast-fed or formula-fed neonates.
Howard CR, Howard FM, and Weitzman ML. Acetaminophen analgesia in neonatal circumcision: the effect on pain. Pediatrics 1994;93(4):641-646.

Behavioral Effects of Circumcision With and Without Anesthesia
Changes in heart rate, respiratory rate, transcutaneous pO2, adrenal cortical hormone secretion, sleep patterns, and behavioral patterns have been shown to be altered during and/or following circumcision of the full-term neonate.
Dixon S, Snyder J, Holve R, Bromberger P. Behavioral effects of circumcision with and without anesthesia. J Dev Behav Pediatr 1984; 5(5): 246-50.

Circumcision I: Effects Upon Newborn Behavior
Our results demonstrate than infants change behaviors after circumcision in about 90 percent of cases. Families, nurses, and physicians have appreciated that babies are different after circumcision, but there have not been controlled studies using the NBAS scale to substantiate these changes... We have shown that behavior differences after circumcision in 4/12 (33%) subjects persisted for at least 22 hours.
Marshall RE, Stratton WC, Moore JA, et al. Circumcision I: effects upon newborn behavior. Infant Behavior and Development 1980;3:1-14.

Circumcision II: Effects Upon Mother-Infant Interaction
The effects of circumcision upon mother-infant interaction were examined in an observational study of 59 mother-infant pairs during hospital feedings using a specifically designed mother-infant interaction observation system that examined 43 discreet behaviours relating to feeding, gaze, facial expression, vocalizations and touch. The experimental group was circumcised after the second feeding and the control group after the fourth feeding... Immediately following circumcision there were differences in the feeding patterns between the two groups. The experimental group exhibited fewer intervals of uninterrupted feeding than did the control group.
Marshall RE, Porter FL, Rogers AG, et al. Circumcision: II effects upon mother-infant interaction. Early Hum Dev 1982; 7(4):367-374.

American Academy of Pediatrics: Breastfeeding and the Use of Human Milk
Breastfeeding should begin as soon as possible after birth, usually within the first hour. Except under special circumstances, the newborn infant should remain with the mother throughout the recovery period. Procedures that may interfere with breastfeeding or traumatize the infant should be avoided or minimized.
American Academy of Pediatrics, Work Group on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics.1997;100 :1035– 1039

The Assessment and Management of Acute Pain in Infants, Children, and Adolescents
Available research indicates that newborn circumcisions are a significant source of pain during the procedure and are associated with irritability and feeding disturbances during the days afterward.
Committee on Psychosocial Aspects of Child and Family Health, American Academy of Pediatrics; Task Force on Pain in Infants, Children, and Adolescents, American Pain Society. The assessment and management of acute pain in infants, children, and adolescents. Pediatrics 2001;108(3):793-7.

www.thewholenetwork.org/

Circoncisione non protegge i gay da Hiv

Gay ou pas, la circoncision ne protège pas du VIH : utilisez un préservatif !

Le professeur Didier Raoult, directeur du laboratoire de microbiologie de Marseille, a récemment tenu des propos choquants et irresponsables. Dans un article du site tetu.com datant du 17 février, il est dit que monsieur Raoult souhaite que l'on pose publiquement la question d'une politique de circoncision visant les gays, en France et en Europe, et ce afin de lutter contre le VIH/SIDA. Voici justement une étude toute récente sur le sujet. 

Extrait

Circoncision et infection au VIH parmi les homosexuels de sexe masculins en Grande Bretagne : le facteur du rôle actif.

Présenté par Rita Doerner (Royaume-Uni). 

R. Doerner¹, E. McKeown¹, S. Nelson², N. Low³, J. Anderson⁴, J. Elford<sup>1 

1</sup>City University, London, United Kingdom, ²Terrence Higgins Trust, Bristol, United Kingdom, ³University of Bern, Bern, Switzerland, ⁴Homerton Hospital NHS Foundation Trust, London, United Kingdom

Contexte : Les preuves que la circoncision réduirait le risque d’être contaminé par le VIH chez les hommes ayant des rapports homosexuels demeurent faibles et inconsistantes. Certaines études suggèrent néanmoins que lors de rapport homosexuels avec pénétration anale, le partenaire ayant un rôle actif dans la pénétration pourrait encourir un risque plus bas d’être infecté. Cette étude examine le lien entre circoncision et prévalence du VIH parmi les homosexuels britanniques de sexe masculin qui assument exclusivement ou principalement un rôle actif lors des pénétrations anales.

Méthode : Plus de 13000 homosexuels de sexe masculin, résidents en Grande Bretagne, ont rempli un questionnaire en ligne, confidentiel et anonyme, en 2007-2008.

Résultats : Cette analyse se concentre sur les 5425 hommes ayant déclaré avoir eu un rapport sexuel non protégé au cours des 3 derniers mois. Parmi ces 5425 hommes, 996 (18.4%) étaient circoncis. L’incidence du VIH était de 12.7% parmi les hommes circoncis et de 11.9% parmi les hommes non circoncis (quotient de possibilités ajusté/OR = 1.07, 95% ; intervalle de confiance/CI = 0.87, 1.32, p=0.51).

Parmi ces 5425 hommes, 1696 (31.3%) ont affirmé avoir principalement ou exclusivement un rôle actif lors des pénétration anales ; 317 de ces hommes (18.7%) étaient circoncis. Chez ces 1696 hommes, aucun lien n’a pu être identifié entre circoncision et prévalence du VIH dans l’analyse univariée (OR 1.06, 95% CI 0.62, 1.83, p=0.8). Après avoir procédé à des ajustements sur la base de l’âge, les rapports anaux non-protégés (donnée concordante ou discordante), de l’utilisation de drogues récréatives, du degré d’optimisme personnel face aux traitements VIH et du lieu de résidence, il n'y avait toujours pas de lien entre circoncision et prévalence du VIH dans ce sous-groupe d'hommes. (OR 0.81, 95% CI 0.44, 1.47, p=0.5).

Conclusion : Dans ce large échantillon d’homosexuels de sexe masculin en Grande Bretagne, il n’y avait aucun lien d’ensemble entre circoncision et prévalence du VIH. Parmi les hommes ayant principalement ou exclusivement un rôle actif lors des pénétrations anales, nous n’avons pas non plus trouvé de lien entre circoncision et prévalence du VIH lors d’analyses multivariées. Ces données suggèrent que même parmi les hommes homosexuels qui ont un rôle principalement actif lors des pénétrations anales, la circoncision ne réduirait pas le risque de contamination au VIH.

Référence : Doerner R et al. Circumcision and HIV infection among men who have sex with men in Britain: the insertive sex role. Archives of Sexual Behavior, early online edition, DOI 10.1007/s10508-012-0061-1, 2013.

Cura dei genitali delle bambine

Genitali delle femminucce: i problemi più comuni

Anche nelle bambine piccolissime si possono presentare piccoli problemi legati all'apparato genitale, le mamme devono quindi saperli riconoscere per intervenire tempestivamente con la terapia giusta o, se necessario, chirurgicamente

Anche nelle bambine piccolissime, così come nei maschietti come vi abbiamo già elencato, si possono presentare piccoli problemi legati all'apparato genitale, le mamme devono quindi saperli riconoscere per intervenire tempestivamente con la terapia giusta o, se necessario, chirurgicamente

Tra i piu' frequenti casi che preoccupano la mamma, la classica "falsa mestruazione" che si manifesta tra la 2° e la 4° settimana di vita della bimba per via del passaggio degli ormoni trasmessi in utero, o ancora le aderenze vulvari che si risolvono in genere nei primi mesi di vita.

FALSA MESTRUAZIONE: puo' capitare che la mamma, cambiando il pannolino alla bimba noti delle goccioline di sangue: non è il caso di preoccuparsi perchè dipendono da una stimolazione degli ormoni materni che durante la vita in utero sono passati ai genitali della bimba e al momento del parto, quando questi calano bruscamente, talvolta provocano delle perdite ematiche proprio come accade col ciclo mestruale. Per tranquillizzarsi ci si puo' rivolgere al pediatra o ad un urologo ma generalmente si risolve tutto in 3/4 giorni e senza nessun intervento nè bisogno di terapia

VULVOVAGINITE: si manifesta con delle secrezioni biancastre e causa fastidio e bruciore, anche durante la minzione e i genitali appaiono arrossati. In genere il problema si presenta quando la bimba inizia asilo o scuola, e cioè quando entra a far parte della "comunita'", puo' essere legata ad una cistite ma se la mamma soffre di infezioni vaginali anche la bimba ne sara' piu' soggetta. Per sapere se si tratta effettivamente di questa infezione e per attuare la giusta terapia si dovra' fare l'urinocoltura, e in alcuni casi un tampone vulvare esterno, e somministrare poi pomate locali o terapie orali. Fondamentale è l'igiene per evitare l'insorgere di infezioni ed irritazioni ed è bene insegnare alla bimba a non trattenere la pipi' e la popo', per evitare il ristagno e favorire cosi' la proliferazione dei germi

ADERENZE VULVARI: chiamate anche sinechie, corrispondono alla fimosi maschile; le piccole labbra appaiono fuse tra loro e e la rima vulvare sembra chiusa lasciando solo un forellino per la fuoriscita della pipi'. Se presenti già' alla nascita sono dovute ad un mancato sviluppo e non corretta maturazione dell'apparato genitale in utero, mentre se compaiono tardivamente (tra i 2 e i 6 anni) sono la conseguenza di infiammazioni locali o infezioni dell'apparato. Quando sono presenti alla nascita bisogna aspettare qualche mese per vedere se si risolvono da sole altrimenti, se dopo l'anno il problema persiste, si puo' provare con delle pomate cortisoniche o con delle manovre manuali (non da effettuarsi a casa!) eseguite da personale esperto in ambiente asettico e sotto leggera anestesia. Se tutto questo si rilevasse inutile,o se le aderenze si riformano,sara' indispensabile un piccolo intervento chirurgico per separare le piccole labbra ed eliminare le aderenze chirurgicamente

 

FONTE: http://www.pianetamamma.it/il-bambino/mala...piu-comuni.html

Possono capitare soprattutto quando le bambine cominciano a frequentare l’asilo o la scuola. Per prevenirle, sono molto importanti le regole igieniche; se i disturbi compaiono, occorre seguire per alcuni giorni una terapia locale.



Le infezioni vaginali possono capitare soprattutto quando le bambine cominciano a frequentare l’asilo o la scuola. Per prevenirle, sono molto importanti le regole igieniche; se i disturbi compaiono, occorre seguire per alcuni giorni una terapia locale.


Infezioni o infiammazioni?

“Innanzitutto dobbiamo distinguere tra infezioni e infiammazioni vaginali” premette Maria Chiara Lucchetti, Responsabile Alta Specializzazione Ginecologia Pediatrica presso l’Ospedale Bambino Gesù di Roma. “La maggior parte di quelle che vengono ritenute infezioni infatti sono banali infiammazioni della mucosa genitale, che però, se trascurate, potrebbero favorire l’accesso di germi”.

Le infiammazioni si manifestano con arrossamento, bruciore, gonfiore della mucosa accompagnati talvolta ad una lieve secrezione di muco; le infezioni sono caratterizzate da secrezione bianco-giallastra un po’ più abbondante, associata spesso a prurito e bruciore durante la minzione, fino a tracce di sangue se la mucosa è particolarmente irritata.

Le cause delle infezioni/infiammazioni

“Le infiammazioni possono avere molteplici cause” prosegue la ginecologa. “La principale è l’uso – e abuso - di detergenti, che, se non vengono risciacquati con cura, restano a contatto con la mucosa vaginale (che non ha le barriere naturali di noi adulte, offerte da peli, muco e grandi labbra più sviluppate). Sul banco degli imputati anche i detersivi – più ammorbidenti e additivi vari – usati per il lavaggio della biancheria intima, di cui spesso restano residui sulle mutandine.

Quanto alle infezioni, a favorirle c’è la vicinanza con le feci (da cui proviene la gran parte dei germi, soprattutto l’Escherichia Coli); “a questo si aggiunge l’abitudine di toccarsi con manine non sempre pulitissime, specie a scuola, dove le bambine di solito vanno in bagno da sole. Si consideri poi che la maggior parte delle volte le infezioni, oltre che di provenienza intestinale, sono di origine respiratoria, provocate dagli stessi virus che provocano i vari raffreddori e che i bambini inconsapevolmente si portano ai genitali attraverso le mani”.


C’è predisposizione alle infezioni?

Le più esposte, sia ad infiammazioni che infezioni, sono le bambine con pelle a tendenza allergica o in cura con antibiotici, che indeboliscono le naturali difese.


Regole di prevenzione
- Dopo la doccia, il bagno o di ritorno dalla piscina, fare un veloce bidet con sola acqua per eliminare residui di detergenti (bagnoschiuma, shampoo, balsamo).
- Non esagerare con l’uso di detersivi e risciacquare accuratamente la biancheria intima.
- Per lavare i genitali, no ai detergenti della mamma, che hanno un pH indicato a chi ha già subito lo sviluppo puberale. Fino all’adolescenza, il detergente migliore è il bicarbonato - 1-2 cucchiai sciolti nella vaschetta del bidet o in una bottiglietta d’acqua – da usare un paio di volte al giorno; in alternativa, può andar bene il sapone di Marsiglia puro, cioè privo di profumazioni o altri additivi, o al massimo un detergente a pH alcalino (superiore a 7).
- Lavare di frequente le mani: è la forma di prevenzione più efficace contro qualunque infezione, delle vie respiratorie e vaginali. L’ideale sarebbe lavarsele sia prima di andare in bagno che dopo.
- Controllare che le bambine vadano in bagno durante il giorno: sovente, concentrate nei giochi, tendono infatti a rimandare la pipì (o a farla frettolosamente, a gambe strette e con indumenti non completamente scesi) e questo aumenta il ristagno delle urine e la concentrazione di batteri.

Come si curano le infezioni/infiammazioni

Per l’infiammazione non c’è una terapia, basta semplicemente evitare il contatto con tutti gli agenti irritanti e mantenere lubrificata la zona con una crema base idratante e lenitiva; da evitare invece le pomate all’ossido di zinco, che ostacolano la corretta traspirazione.
Se si sospetta un’infezione, è consigliabile una visita del pediatra che, in caso di dubbio, prescriverà un tampone vaginale (si può fare anche alle bambine, perché si raccoglie solo la secrezione esterna). Per curarla, si applica esternamente una pomata per 4-5 giorni; solo se non passa, potrebbe essere necessaria una terapia orale ed eventualmente una visita dallo specialista.

 

FONTE: http://www.nostrofiglio.it/bambino-3-6-ann...li_bambine.html

Infezioni alle vie urinarie nei bambini

Infezioni alle vie urinarie nei bambini

Le infezioni alle vie urinarie nei bambini: come riconoscerle e curarle. Generalmente non si tratta di disturbi gravi ma è importante riconoscerli e curarli tempestivamente perchè, se trascurati, possono danneggiare i reni

Le infezioni delle vie urinarie (IVU) sono molto frequenti in età pediatrica tanto che la loro incidenza è stimata nel 7,5% tra i bambini che si presentano al pronto soccorso con febbre che supera i 38°C. Generalmente non si tratta di disturbi gravi ma è importante riconoscerli e curarli tempestivamente perchè, se trascurati, possono danneggiare i reni. Nei neonati (sotto il 1 anno di vita) il rischio di contrarre un'infezione alle vie urinarie (anche se alcuni studi più recenti smentirebbero questo) è maggiore nei maschietti rispetto alle femminucce, con una percentuale rispettivamente del 7% e del 3,2%. Questo perchè c'è una maggiore frequenza di malformazioni delle vie urinarie nei neonati maschi.
Nei bambini al di sotto degli 11 anni la situazione si capovolge, ossia il rischio risulta maggiore nelle femmine rispetto ai maschi per via della vicinanza del retto all'uretra. La causa principale dell'insorgenza delle infezioni alle vie urinarie è la presenza di batteri, mentre più raramente l'infezione può essere originata da virus o funghi. Le forme più frequenti di infezioni delle vie urinarie si dividono in tre categorie:

Batteriuri asintomatica: è una patologia di lieve entità che non presenta sintomi ed è provocata da batteri a bassa virulenza. Si individua in genere attraverso esami delle urine o urinocolture occasionali e non richiede una terapia, tranne che per i pazienti immunodepressi (portatori di trapianto renale, diabetici, etc.).

Infezione urinaria bassa sintomatica o cistite acuta: può essere favorita da fattori locali, quali infezioni vaginali e del glande, fimosi (restringimenti), sinechie (aderenze) delle piccole labbra etc. Tra i sintomi prevalgono i disturbi nella minzione con febbre che generalmente non supera i 38° C. Nel lattante i sintomi possono essere aspecifici. Alle volte può comparire sangue nelle urine alla fine della minzione, anche con coaguli. Dall'esame ecografico si può individuare un aumento dello spessore della parete vescicale. Questa tipologia di infezione riguarda principalmente le bambine in età prescolare

Infezioni urinarie basse ricorrenti: sono molto frequenti nelle femmine in età scolare e sono spesso associate a disfunzioni vescicali e dello sfintere uretrale esterno

Nel 30 - 40% dei casi si associano a reflusso vescico-uretrale, di solito di lieve entità. È frequente la concomitanza con vulvo-vaginiti, sinechie delle piccole labbra e stipsi. La terapia può comprendere, oltre ad un trattamento specifico antibatterico, anche una rieducazione minzionale e l'utilizzo di farmaci che regolano la muscolatura vescicale

Infezione urinaria alta o pielonefrite acuta (PNA): è caratterizzata generalmente da febbre elevata accompagnata da brividi e dolori lombari o addominali. Questo tipo di infezione non è sempre facile da diagnosticare ed spesso associata ad una malformazione delle vie urinarie (nel 40% dei casi a reflusso vescico-uretrale) e/o a disfunzioni.

Per riconoscere un'infezione delle vie urinarie è molto importante individuare i sintomi che, come abbiamo visto, non sempre sono specifici o eclatanti. Ad esempio nei lattanti e nei neonati il sospetto di un'infezione di questo tipo deve nascere anche in presenza di sintomi aspecifici come febbre, irritabilità, scarso aumento di peso, pianto durante la minzione, disturbi gastroenterici, urina maleodorante, arrossamento all'interno delle cosce e ittero. Nei bambini più grandi invece occorre fare attenzione alla presenza di disturbi minzionali, cioè se il piccolo avverte dolore nella zona lombare o bruciore mentre fa pipì e se si verificano episodi di incontinenza.

In presenza di tali sintomi è necessario rivolgersi subito al medico. La diagnosi sulla presenza o meno di infezioni alle vie urinarie è possibile attraverso due esami specifici: l'esame completo delle urine e l'urinocoltura. Questi esami devono essere effettuati prima d'iniziare l'eventuale terapia con gli antibiotici perchè anche una sola dose di antibiotico può rendere sterili le urine impedendo quindi di identificare il germe responsabile dell'infezione. Altri esami che vengono effettuati una volta che l'infezione è passata sono l'ecografia renale e la cistografia.

Soprattutto nel caso di infezioni alte può essere eseguita anche una scintigrafia renale statica al fine di valutare gli eventuali esiti dopo un certo periodo di tempo. Nel caso delle infezioni delle basse vie urinarie si interviene in genere con un ciclo di 3-5 giorni di terapia antibatterica per via orale. Con cicli di questa durata è possibile prevenire gli effetti collaterali degli antibiotici e le alterazioni della flora batterica intestinale.

Se si è in presenza di una infezione alle alte vie urinarie il ciclo di terapia deve avere una durata maggiore (almeno 10 giorni). Una volta diagnosticata un'infezione del genere, come nel caso della pielonefrite acuta, la terapia va iniziata prima possibile. Infatti se si interviene tempestivamente, entro 48-72 ore dall'esordio dell'infezione, è possibile prevenire i possibili danni ai reni. A seconda dei sintomi e dell'età del bambino la terapia può essere effettuata a casa oppure in ospedale. Il ricovero viene in genere consigliato per i bambini più piccoli in presenza di febbre elevata, vomito o segni di disidratazione

The Development of Foreskin Retraction in the Child & Adolescent

Detailed information on the normal development of the foreskin and its natural separation process.

Written by: Doctors Opposing Circumcision
(see the original article here)

Introduction
There is much uncertainty among health care workers about when the foreskin of a boy should become retractable.1 This has caused many false diagnoses of phimosis, followed by unnecessary circumcision, when, in fact, the foreskin is developmentally normal.

History
The first data on development of retractile foreskin were provided in 1949 by the famous British paediatrician, Douglas Gairdner.2 His data have been incorporated into many textbooks and still is repeated in the medical literature today. Gairdner said that 80 percent of boys should have a retractable foreskin by the age of two years, and 90 percent of boys should have a retractable prepuce by the age of three years.2

Unfortunately, Gairdner’s data are inaccurate,3-4 so most healthcare providers have been taught inaccurate data.4 Retractability usually occurs much later than previously believed.3 This page provides accurate data, derived from newer and better studies, for healthcare providers.

Current View
Almost all boys are born with the foreskin fused with the underlying glans penis. Most also have a narrow foreskin that cannot retract. Non-retractile foreskin is normal at birth and remains common until after puberty (age 18). Some boys develop retractile foreskin earlier, and about 2 percent of males have a non-retractile foreskin throughout life. Non-retractile foreskin is not a disease and does not require treatment.

There are three possible conditions that cause non-retractile foreskin:

• Fusion of the foreskin with the glans penis
• Tightness of the foreskin orifice
• Frenulum breve (which is rare and cannot be diagnosed until the previous two reasons have been eliminated)

The first two reasons are normal in childhood and are not pathological in children. The third can be treated conservatively, retaining the foreskin.

Infants and pre-school
Kayaba et al. (1996) reported that before six months of age, no boy had a retractable prepuce; 16.5 percent of boys aged 3-4 had a fully retractable prepuce.5 Imamura (1997) examined 4521 infants and young boys. He re-ported that the foreskin is retractile in 3 percent of infants aged one to three months, 19.9 percent of those aged ten to twelve months, and 38.4 percent of three-year-old boys.6 Ishikawa & Kawakita (2004) reported no retractability at age one, (but increasing to 77 percent at age 11-15).7 Non-retractile foreskin is the more common condition in this age group. Compare these data with Gairdner’s data!

Percentage of boys with fused foreskin by age
according to Øster

School-age and adolescence
Jakob Øster, a Danish physician who conducted school examinations, reported his findings on the examination of school-boys in Denmark, where circumcision is rare.8 Øster (1968) found that the incidence of fusion of the foreskin with the glans penis steadily declines with increasing age and foreskin retractability increases with age.8 Kayaba et al. (1996) also investigated the development of foreskin retraction in boys from age 0 to age 15.5 Kayaba et al. also reported increasing retractability with increasing age. Kayaba et al. reported that about only 42 percent of boys aged 8-10 have fully retractile foreskin, but the percentage increases to 62.9 percent in boys aged 11-15.5 Imamura (1997) reported that 77 percent of boys aged 11-15 had retractile foreskin.6 Thorvaldsen & Meyhoff (2005) conducted a survey of 4000 young men in Denmark.9 They report that the mean age of first foreskin retraction is 10.4 years in Denmark.9 Non-retractile foreskin is the more common condition until about 10-11 years of age.

Percentage of boys with tight ring totally non-retractile foreskin
according to Kayaba et al.

Discussion
Boys usually are born with a non-retractile foreskin. The foreskin gradually becomes retractable over a variable period of time ranging from birth to 18 years or more.8,9 There is no “right” age for the foreskin to become retractable. Non-retractile foreskin does not threaten health in childhood and no intervention is necessary. Many boys only develop a retractable foreskin after puberty. Education of concerned parents usually is the only action required.10

Avoidance of premature retraction
Care-givers and healthcare providers must be careful to avoid premature retraction of the foreskin, which is contrary to medical recommendations, painful, traumatic, tears the attachment points (synechiae), may cause infection, is likely to generate medico-legal problems, and may cause paraphimosis, with the tight foreskin acting like a tourniquet. The first person to retract the boy’s foreskin should be the boy himself.3

Making the foreskin retractable
Occasionally a male reaches adulthood with a non-retractile foreskin. Some men with a non-retractile foreskin happily go through life and father children. Other men, however, may want to make their foreskin retractile.

The foreskin can be made retractable by:

• Manual stretching11-12
• Application of topical steroid ointment13-14

Male circumcision is outmoded as a treatment for non-retractile foreskin, but it is still recommended by many urologists because of lack of adequate information, and perhaps because of the fees associated with circumcision. Nevertheless, circumcision should be avoided because of pain, trauma, cost,15,16 complications,15 difficult recovery, permanent injury to the appearance of the penis, loss of pleasurable erogenous sensation,17 and impairment of erectile and ejaculatory functions.18-20

References:

1. Simpson ET, Barraclough P. The management of the paediatric foreskin. Aust Fam Physician 1998;27(5):381-3. [Full Text]
2. Gairdner D. The fate of the foreskin: a study of circumcision. Br Med J 1949;2:1433-7. [Full Text]
3. Wright JE. Further to the "Further Fate of the Foreskin." Med J Aust 1994;160:134-5. [Full Text]
4. Hill G. Circumcision for phimosis and other medical indications in Western Australian boys. Med J Aust 2003;178(11):587. [Full Text]
5. Kayaba H, Tamura H, Kitajima S, et al. Analysis of shape and retractability of the prepuce in 603 Japanese boys. J Urol 1996;156(5):1813-5. [Full Text]
6. Imamura E. Phimosis of infants and young children in Japan. Acta Paediatr Jpn 1997;39(4):403-5. [Abstract]
7. Ishikawa E, Kawakita M. [Preputial development in Japanese boys]. Hinyokika Kiyo 2004;50(5):305-8. [Abstract]
8. Øster J. Further fate of the foreskin: incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys. Arch Dis Child 1968;43:200-3. [Full Text]
9. Thorvaldsen MA, Meyhoff H. Patologisk eller fysiologisk fimose? Ugeskr Læger 2005;167(17):1858-62. [Full Text]
10. Spilsbury K, Semmens JB, Wisniewski ZS. et al. Circumcision for phimosis and other medical indications in Western Australian boys. Med J Aust 2003 178 (4):155-8. [Full Text]
11. Dunn HP. Non-surgical management of phimosis. Aust N Z J Surg 1989;59(12):963. [Full Text]
12. Beaugé M. The causes of adolescent phimosis. Br J Sex Med 1997; Sept/Oct: 26. [Full Text]
13. Orsola A, Caffaratti J, Garat JM. Conservative treatment of phimosis in children using a topical steroid. Urology 2000;56(2):307-10. [Full Text]
14. Ashfield JE, Nickel KR, Siemens DR, et al. Treatment of phimosis with topical steroids in 194 children. J Urol 2003;169(3):1106-8. [Abstract]
15. Van Howe RS. Cost-effective treatment of phimosis. Pediatrics 1998; 102(4)/e43. [Full Text]
16. Berdeu D, Sauze L, Ha-Vinh P. Blum-Boisgard C. Cost-effectiveness analysis of treatments for phimosis: a comparison of surgical and medicinal approaches and their economic effect. BJU Int 2001;87(3):239-44. [Full Text]
17. Williams N, Kapila L. Complications of circumcision. Brit J Surg 1993;80:1231-6. [Full Text]
18. Denniston GC, Hill G. Circumcision in adults: effect on sexual function. Urology 2004;64(6);1267. [Full Text]
19. Shen Z, Chen S, Zhu C, et al. [Erectile function evaluation after adult circumcision]. Zhonghua Nan Ke Xue 2004;10(1):18-9. [Abstract]
20. Masood S, Patel HRH, Himpson RC, et al. Penile sensitivity and sexual satisfaction after circumcision: Are we informing men correctly? Urol Int 2005;75(1):62-5. [Full Text]

Glande arrossato

Un Glande arrossato: Balanite, Balanopostite, o un'altra cosa? Quando non sottovalutarlo?

La Balanopostite e la Balanite sono due patologie infiammatorie o infettive del Glande (Balanite) da solo o del Glande e del prepuzio, il foglietto di pelle che lo ricopre (Balanopostite), ma spesso non sempre quello che sembra è poi confacente alla realtà.

in merito a questa situazione a carico di questo organo genitale dell'uomo, ma mi preme in queste pagine sottolineare l'importanza di una valutazione dermatologico - venereologica in taluni casi:

Un glande arrossato non sempre è una infezione: anzi molto spesso questa situazione cela altre storie, che dirigono il clinico dermatologo verso patologie di diversa natura che una infezione.

Pertanto ecco un vademecum composto dai "15 punti d'oro" per orientarsi se si è in presenza di un disturbo o fastidio di quella particolare zona dell'uomo; questo elenco servirà se ben seguito a decidere se e quando fare una visita:

__________________________________

1. in presenza di 1 macchia fissa a carico del glande o a cavallo fra glande e prepuzio interno (come un foglio che addossato su una superficie colorata di fresco,si impregna di colore anch'esso, per intenderci)

2. in presenza di 1 o più macchie che appaiono e scompaiono cambiando di sede per un pò di tempo

3. in presenza di una produzione eccessiva di sostanza biancastra nonostante la detersione appropriata a carico del glande

4. in presenza di una erosione, ovvero, una perdita di una parte superficiale di mucosa del glande e/o del prepuzio

5. in presenza di un'area rosso vivo, che può sembrare quasi laccata sempre a carico del glande

6. in presenza di un'aderenza (attaccatura, saldatura) fra la corona (la parte finale del glande, quella più larga dove parte il prepuzio interno) e il prepuzio stesso

7. in presenza di una macchia bianca o biancastra a carico del glande, o del prepuzio esterno od interno associata ad una difficoltà ad aprire il glande (scorrimento prepuzio)

8. in presenza di un'ulcera del glande o del prepuzio, ovvero una perdita di sostanza che scopre un fondo sanioso (sanguinolento)

9. in presenza di qualsiasi vescicola o "bollicina" : spesso queste si parono facilmente lasciando piccore aree rosse e lievemente erose ("sbucciate")

10. in presenza di una qualsiasi lesione del glande o del prepuzio o del pube associata ad una linfoadenopatia (un linfonodo gonfio, un bozzetto inguinale che può essee palpato anche in modo indolente)

11. in presenza di prurito o di un bruciore costante od intermittente che non recede nell'arco di alcuni giorni

12. in presenza di papule, lesioni cupoliformi dello stesso colore della pelle, liscie o irregolari

13. in presenza di macchie scure, marroni o nerastre che insorgono di recente o che non si erano notate in precedenza

13. in presenza di una alterazione del getto dell'urina o in presenza di qualsiasi corpo estraneo che aggetta nel meato uretrale (una qualsiasi escrescenza o placchetta o modificazione del "buchetto" ove esce l'urina sulla punta del glande)

14. in presenza di una alterazione del frenulo (il filetto che lega il prepuzio con la parte ventrale del glande vicino il meato uretrale), una frattura, uno sbiancamento, un irrigidimento, un sanguinamento

15. in presenza di una secchezza estrema, uno sbriciolamento continuativo della mucosa del glande, una difficoltà a scorrere il prepuzio sul glande

In questi casi, potrebbe essere molto utile la visita Venereologica, con lo Specialista esperto di patologie della cute e delle mucose genitali

A CURA DEI MEDICI ITALIANI

Il Prepuzio

Normal development of the prepuce:
Birth through age 18

Introduction

The genital organs are in a very immature stage of development at birth. The growth and development continues through puberty and into adulthood. This page and the indexed articles provide information on that normal development. Articles are indexed in chronological order.

"The Phony Phimosis Diagnosis"

The normal growth and development of the prepuce of the human male has been greatly misunderstood both by the medical community and by the public. This misunderstanding has led to many unnecessary, contraindicated circumcisions being performed on young boys.

Typically, when a baby boy is born, the prepuce is long with a narrow tip.^4,5 Retraction is not possible in the majority of infants because the narrow tip will not pass over the glans penis. Moreover, the inner mucosal surface of the prepuce is fused with the underlying mucosal surface of the glans penis.^2,4,6,11 This also prevents retraction. This normal developmental narrowness is sometimes improperly diagnosed as phimosis (a fairly rare pathological condition, characterized by hardening of the tip of the foreskin, and a whitish ring of hardened tissue). In fact, the normal developmental narrowness is not phimosis. It is simply a normal stage of development.

The fusion of the foreskin to the underlying glans penis is often improperly called "adhesions." The fused foreskin and glans sometimes will separate by age 3-5, but usually this takes longer. Øster observed boys in which this normal process was not completed until after puberty.⁶

Fig. 1 Non-retractile foreskin of infant boy
(normal for age) BMJ 1996;312:299.

As the infant matures into a boy and the boy into a man, a number of changes occur: The tip of the prepuce becomes wider, the tip seems to become shorter as the shaft of the penis grows. The membrane that bonds the inner surface of the prepuce with the glans penis spontaneously disintegrates and releases the prepuce to separate from the glans. The prepuce spontaneously becomes retractable.

Fig. 2 Normal foreskin at 15 months of age.

Many medical doctors in the United States receive no training in the normal development of the prepuce. Thus they improperly diagnose a normal developmental condition as "phimosis."⁹

As noted above, a large number of medical doctors have not had the benefit of the information contained on this page, because it has not become part of the standard medical curriculum. Many physicians today are unable to distingish between normal developmental tightness (as described here) and clinical phimosis. Nor are they able to answer with accuracy when the prepuce should become retractable.⁹ These ill-trained doctors may attempt to prematurely retract the foreskin which is traumatic for the child.⁹ Parents should guard against this possibility.

The prepuce contains muscle fibers that work to keep the tip closed when the child is not urinating.^1,9 This may cause parents and physicians to believe that the opening is smaller than it really is. Catzel explains how to examine a child's prepuce correctly to avoid misdiagnosis.¹¹

The false diagnosis of phimosis in boys is very common in the United States and the United Kingdom. See here for more information.

Ballooning

There is a phase of development during which some boys may experience "ballooning." Ballooning is the inflation of the prepuce during urination by the pressure of urine inside. This can occur if the inner layer of the prepuce is separating or has separated from the glans, which typically happens around three years of age, before the prepuce has become fully retractable. Ballooning is an indication that the normal separation of the foreskin from the glans penis has occurred. Ballooning is a transient condition that goes away as the prepuce continues its natural growth and development and the opening at the tip further enlarges. Babu et al. report that ballooning does not interfere with voiding.²⁰ Ballooning is not injurious, and it is not a cause for concern. Ballooning is not an indication for circumcision.

The maturation of the penis may take years to complete. Each boy develops at his own rate. The maturation of the prepuce continues beyond puberty as described below.

The appearance of the infant penis does not reflect on the appearance of the adult penis. Sexual development after puberty causes many changes, which include retractibility of the foreskin.

Douglas Gairdner (1949)

Gairdner, a British pediatrician, observed 100 newborns and about 200 boys of varying ages through age 5. Gairdner reported that 4% of newborns had a fully retractable prepuce, In 54% the glans could only be uncovered enough to reveal the external meatus, and in 42% even the tip of the glans could not be uncovered. He also said that, in boys of six months of age, four out of five or 80% still had non-retractable prepuces. By 1 year of age, 50% still had non-retractable prepuces. By two years about 20% and by 3 years about 10% of boys still had a non-retractable prepuce.⁴

Gairdner also noted that the separation of the prepuce was incomplete at these ages and this incomplete separation is the cause of the non-retractabality. He said the surfaces should not be torn apart because this causes bleeding and infection. Gairdner provided a table which showed:

Age Percent retractable. Birth 4 Age 1 50 Age 2 75 Age 3 90 Age 4 91 Age 5 92

Gairdner in 1949 had collected no data beyond age 5, which led some authors improperly to assume that circumcision was necessary if the prepuce was not retractable by that age.

Gairdner's figures on percentage of retractability, collected in the 1940s,⁴ are now known to be too high.^{12 17,18} Unfortunately, many doctors still erroneously use these outmoded figures and this causes improper diagnosis of phimosis in normal boys and leads to unnecessary circumcisions. Later studies^{6,13,14, 16} have indicated that only about 40-50 percent of boys have fully retractable foreskins at age ten. (see below).

Jakob Øster (1968)

The normal development of the prepuce beyond age 5 was first documented by Jakob Øster, a Danish pediatrician, who published his work in 1968.⁶

Øster reported progressive increase in the retractability of the prepuce with increasing age. Øster, a school health officer, was responsible for the physical examinations of large numbers of boys of school age. Neonatal circumcision is not practiced in Denmark, so all of the boys were intact. Øster conducted examinations of boys aged 6 to 17 years old from school year 1957-58 through 1964-65.

Øster classified two grades of tightness of the prepuce: A non-retractable prepuce was termed phimosis, and a prepuce that could be retracted with difficulty he called tight prepuce. He found that the percentage of boys with "phimosis" or "tight prepuce" steadily declined with increasing age. Dr. Øster's work is presented in his article in such a fashion that it is somewhat difficult to understand. He presented findings on "phimosis", "tight prepuce" and "adhesions" separately. Actually, all of those conditions prevent free and easy retraction of the foreskin so it is necessary to consider incidence of the three conditions together to determine the percentage of boys that have complete retractability. The Circumcision Reference Library restates Øster's work here by combining his findings into one table. The combined total of boys by age who do not have complete retractability is shown in the table:

Øster's6 Retraction Data Restated17
Age	Phimosis	Tight prepuce	Not fully separated	Total percent non-retractable	Total percent retractable
6-7	8%	6%	63%	77%	23%
8-9	6%	2%	58%	66%	34%
10-11	6%	2%	48%	56%	44%
12-13	3%	3%	34%	40%	60%
14-15	1%	1%	13%	15%	85%
16-17	1%	1%	3%	5%	95%

Øster's figures refute Gairdner's claims that 90 percent are retractable at age five, Øster found that the 90 percent retractable stage is not reached until about age 16.

Grogono (1979)

E. B. Grogono, a school medical officer, observed that boys, with a non-retractile prepuce at age 11, have a fully retractile prepuce by age 14 or 15. Grogono further reported that the non-retractile prepuce caused no problems.⁸

Hiroyuki Kayaba (1996)

Kayaba, a Japanese doctor, recorded the findings on examination of 603 Japanese boys.¹³ Kayaba classified the prepuce types into five categories. Kayaba noted a steady progression to increasing retractability with increasing age.¹³

Kayaba's work refutes the findings of Gairdner and confirms the work of Øster. Kayaba reported that about 40 percent of boys in the 8-10 age group are fully retractable, this leaving about 60 percent with some degree of non-retractability, He also reported that 62.9 percent of the boys in the 11 to 15 year old age group had completely retractable prepuces, thus leaving 37.1 percent with some degree of non-retractability. The prepuce is still developing in the 11-15-year-old group. Kayaba's findings are similar to those of Øster.

Kayaba made no reports beyond age 15.

Kayaba's report thus confirms the work of Øster; we see that full retractability is not reached by about 1/2 of boys until the teen-age years. This is normal, and treatment is usually not required.

Imamura (1997)

Imamura's study, carried out in Japan, shows that the non-retractile prepuce is the normal condition in preschool age boys.¹⁴ Imamura found that only 38.4 percent of children three years old have a fully retractable prepuce. Imamura's data are similar to that of Kayaba.¹³ Imamura advises that no treatment is necessary for non-retractile prepuce.¹⁴ Imamura's findings¹⁴ provide further evidence of the incorrectness of Gairdner's⁴ data.

Cold & Taylor (1999)

Fig. 2. Incidence of preputial adhesions in various age groups, after Øster [20].	Fig. 3. Retractability of the prepuce in various age groups. After Kayaba et al.[22]. The tight preputial ring is shown in green and the type IV and V as red; a type IV prepuce retracts to the glans corona and type V retracts to completely expose the glans.

Drs. Christopher J. Cold and John R. Taylor have included a discussion of the normal development of the prepuce under the "Embryology" heading of their landmark article on the human prepuce.¹⁵ The development of retractability is shown in graphic form.

Concepción-Morales (2002)

A study performed in Cuba by Concepción-Morales et al. further confirms the work of Øster and Kayaba. The work, published in Spanish, has an English language abstract.¹⁶

Ishikawa and Kawakita (2004)

Ishikawa and Kawakita investigated preputial retractability in 242 Japanese boys. They found that no boys had a retractable prepuce at birth but in the age group 11-15, 77 percent had a retractable prepuce while 23 percent remained non-retracable. This confirms previous evidence that, for many boys, the prepuce does not become retractable until after puberty.¹⁹

Thorvaldsen and Meyhoff (2005)

Thorvaldsen conducted a survey of young men in Denmark. They found that the average age of first foreskin retraction is 10.4 years.²¹

Agawal, Mohta, and Anand (2005)

Agawal, Mohta, and Anand carried out a study in Delhi, India of boys up to age 12. Their study found that preputial retractability continues to develop through age 12, confirming the work of Oster (1968), Kayaba et al. (1996), and Thorvaldsen (2005).²²

Beyond age 18

There are no studies in the medical literature of development of the prepuce beyond age 18. Anecdotal evidence indicates that most of the few males who still have a tight prepuce at age 18 find that the prepuce eventually stretches and enlarges so that full retractability of the foreskin is obtained in the early 20s.

Conclusion

Almost all boys are born with narrow non-retractile foreskin which are fused with the glans beneath. This is a normal developmental physiological condition and is not a cause for concern. Some parents needlessly worry that the opening is not large enough.

Retraction of the foreskin should never be forced. It will retract when it is ready. There is no "right" age for retraction to occur.

A narrow non-retractable prepuce in boys is within the normal range of development and usually causes no problems. The prepuce usually will spontaneously widen until complete retractability is obtained. About 50-60 percent of boys at age ten do not have fully retractable foreskins.¹⁷ This is normal.¹⁷ After puberty, the percentage of boys with full retractability rapidly increases spontaneously.¹⁷

If a narrow or non-retractile prepuce becomes a problem, a wide variety of conservative alternative treatments to circumcision are are now available. Circumcision is an outmoded, radical, traumatic, disproportionate, unnecessary surgery for a minor problem.

After you have studied this page and its linked articles, you will know more about the normal development of the prepuce than most medical doctors.

Library Holdings

1. Jefferson G. The peripenic muscle; Some observations on the anatomy of phimosis. Surgery, Gynecology, and Obstetrics (Chicago) 1916;23(2):177-181.
2. Deibert, GA. The separation of the prepuce in the human penis. Anat Rec 1933;57:387-399.
3. Hunter RH. Notes on the development of the prepuce. J Anat 1935;70(1):68-75.
4. Gairdner D. The fate of the foreskin. Brit Med J 1949:2:1433-7.
5. Spence J. On Circumcision. Lancet 1964;2:902.
6. Øster J. Further Fate of the Foreskin: Incidence of Preputial Adhesions, Phimosis, and Smegma among Danish Schoolboys. Arch Dis Child, April 1968. p. 200-202.
7. Wright, Joyce. Nature's assurance that the uncircumcised glans penis will function smoothly is provided by smegma. Sexology (New York), Vol 37, no. 2 (September 1970) pp. 50-53.
8. Grogono EB. The case against circumcision. Br Med J 1979;1:1423.
9. Lakshmanan S, Prakash S. Human prepuce: Some aspects of structure and function. Indian Journal of Surgery 1980;(44):134-7.
10. Osborn LM. Metcalf TJ, Mariani EM. Hygienic care in uncircumcised infants. Pediatrics 1981; 67:365-7.
11. Catzel P. The normal foreskin in the young child. (letter) S Afr Mediense Tysskrif [South Afr Med J] 1982 (13 November 1982) 62:751.
12. Wright JE. Further to "The further fate of the foreskin": Update on the natural history of the foreskin. Medical Journal of Australia (7 February 1994) ;160:134-135.
13. Kayaba H, et al. Analysis of shape and retractability of the prepuce in 603 Japanese boys. Journal of Urology, 1996;156(5):1813-1815.
14. Imamura E. Phimosis of infants and young children in Japan. Acta Paediatr Jpn 1997;39(4):403-5.
15. Cold CJ, Taylor JR. The prepuce. BJU Int 1999;83 Suppl. 1:34-44.
16. Morales Concepción JC, Cordies Jackson E, Guerra Rodriguez M, et al. ¿Debe realizarse circuncisión en la infancia. Arch Esp Urol 2002;55(7):807-11.
17. Hill G. Circumcision for phimosis and other medical indications in Western Australian boys (Letter). Med J Aust 2003;178(11):587.
18. Hill G. Triple incision to treat phimosis in children: an alternative to circumcision (letter). BJU Int 2004;93(4):636.
19. Ishikawa E, Kawakita M. [Preputial development in Japanese boys]. Hinyokika Kiyo 2004;50(5):305-8.
20. Babu R, Harrison SK, Hutton KA. Ballooning of the foreskin and physiological phimosis: is there any objective evidence of obstructed voiding? BJU Int 2004;94(3):384-7.
21. Thorvaldsen MA, Meyhoff H. Patologisk eller fysiologisk fimose? Ugeskr Læger 2005;167(17):1858-62.
22. Agawal A, Mohta A, Anand RK. Preputial retraction in children. J Indian Assoc Pediatr Surg 2005;10(2):89-91.
23. Ko MC, Lui CK, Lee WK, et al. Age-specific prevalence rates of phimosis and circumcision in Taiwanese boys. J Formos Med Assoc 2007;106(4):302–7.

Information for parents

The following pamphlets have been prepared for the information of parents:

• Newborns: Care of the Uncircumcised Penis. Elk Grove Village: American Academy of Pediatrics, 1984.
• Peron JE. Care of the intact penis. Midwifery Today (November) 1991; Issue 17:24. (Childbirth Education Foundation, Oxford, PA.)
• Questions about your son's intact penis. San Anselmo: NOCIRC, 1997. (Link to www.nocirc.org)
• Care of the Uncircumcised Penis. Elk Grove Village, IL: American Academy of Pediatrics, 1999.
• Questions About Premature (Forcible) Retraction of Your Young Son's Foreskin. (Pamphlet) San Anselmo: NOCIRC, 2000. (Link to www.nocirc.org)
• American Academy of Pediatrics. Care of the Uncircumcised Penis. Elk Grove Village, IL: American Academy of Pediatrics, 2000.
• Circumcision: Information for Parents. Ottawa: Canadian Paediatric Society, November 2004.

External irritants can sometimes cause a previously retractable prepuce to become non-retractable due to swelling of the tissues. If a child whose prepuce was retractable becomes non-retractable, environmental factors should be investigated. One known culprit is bubble bath. If a child is taking bubble baths and the prepuce becomes non-retractable, the bubble bath should be discontinued. See Penile Hygiene in the Intact Non-circumcised Male for comprehensive information on foreskin care.

Circoncisione: nessun beneficio per Hiv o Mst

PUERTO RICO: No benefit from circumcision for HIV, STDS



Puero Rico: Circumcision not protective
Circumcision does not protect men against HIV or other sexually transmitted diseases, according to a study conducted in Puerto Rico.

The 660 men were randomly sampled from an STD clinic waiting room. Almost a third of them were circumcised.

The circumcised men reported significantly (but not greatly) more STDs in their lifetimes, were more likely to have been diagnosed with warts, and were more likely to have HIV.

J Sex Med. 2012 Aug 15. doi: 10.1111/j.1743-6109.2012.02871.x.

More than Foreskin: Circumcision Status, History of HIV/STI, and Sexual Risk in a Clinic-Based Sample of Men in Puerto Rico.

Rodriguez-Diaz CE, Clatts MC, Jovet-Toledo GG, Vargas-Molina RL, Goldsamt LA, García H.

Medical Sciences Campus-School of Public Health, University of Puerto Rico, San Juan, Puerto Rico National Development and Research Institutes, New York, NY, USA Centro Latinoamericano de Enfermedades de Transmisión Sexual, Puerto Rico Department of Health, San Juan, Puerto Rico.

Abstract

Introduction. Circumcision among adult men has been widely promoted as a strategy to reduce human immunodeficiency virus (HIV) transmission risk. However, much of the available data derive from studies conducted in Africa, and there is as yet little research in the Caribbean region where sexual transmission is also a primary contributor to rapidly escalating HIV incidence.

Aim. In an effort to fill the void of data from the Caribbean, the objective of this article is to compare history of sexually transmitted infections (STI) and HIV diagnosis in relation to circumcision status in a clinic-based sample of men in Puerto Rico.

Methods. Data derive from an ongoing epidemiological study being conducted in a large STI/HIV prevention and treatment center in San Juan in which 660 men were randomly selected from the clinic's waiting room.

Main Outcome Measures. We assessed the association between circumcision status and self-reported history of STI/HIV infection using logistic regressions to explore whether circumcision conferred protective benefit.

Results. Almost a third (32.4%) of the men were circumcised (CM). Compared with uncircumcised (UC) men, CM have accumulated larger numbers of STI in their lifetime (CM = 73.4% vs. UC = 65.7%; P = 0.048), have higher rates of previous diagnosis of warts (CM = 18.8% vs. UC = 12.2%; P = 0.024), and were more likely to have HIV infection (CM = 43.0% vs. UC = 33.9%; P = 0.023). Results indicate that being CM predicted the likelihood of HIV infection (P value = 0.027).

Conclusions. These analyses represent the first assessment of the association between circumcision and STI/HIV among men in the Caribbean. While preliminary, the data indicate that in and of itself, circumcision did not confer significant protective benefit against STI/HIV infection. [Actually, what the the data indicate is that intactness confers significant protection, compared to being circumcised.] Findings suggest the need to apply caution in the use of circumcision as an HIV prevention strategy, particularly in settings where more effective combinations of interventions have yet to be fully implemented.

Oltre 700 medici, giuristi contro la circoncisione

Open letter to the circumcision "Religious freedom can not be an excuse for violence"

The circumcision debate on FAZ.NET appeal more than 700 physicians and lawyers in federal government and parliament to protect the children more.

All we can say is medically clear that there are no medical reasons for removal of a healthy prepuce in a healthy, incompetent little boy


Oltre 700 medici, psicologi, giuristi, scienziati contro la circoncisione rituale-religiosa, per i diritti dei bambini:

The co-signer:

• Prof. Dr. Jörg Abbing, St. Wendel
• Graduate economist Nicola Abu-Khalil, a board member of the Refugee Council of Schleswig-Holstein
• Prof. Dr. Dieter Adam, Munich
• Lutz eagle, 1 Chairman of the DEMO (The former child victims) National Association Hessen eV
• Mina Ahadi, chairwoman Central Council of Ex-Muslims
• lawyer Franz Albrecht, Marktredwitz / Upper Franconia
• Dr. Rudolf Albrecht, Vienna
• Dr.Irmgard Albrecht, Marktredwitz
• Prof. Dr. Heiko Alfke, EBIR, Director, Department of Diagnostic and Interventional Radiology, Klinikum Lüdenscheid
• Lawyer Oliver Allesch, Food
• Prof. Hartmut Amft, Professor of Social Medicine Emeritus, Zollikon, Switzerland
• Norbert Andersch MD, MRC Psych, neurologist / psychiatrist, London and Praelo (It)
• Dr. Hellmut Anger, Doctor, Bielefeld
• Dr. jur. Alexander Archangelsky, Berlin
• Dr. Jens-Uwe Asmussen, specialist in general medicine and surgery, Gross Wittensee
• Lawyer Seyran Ates, Berlin
• Thomas Baader, spokesman of Peri Association for Integration and Human Rights eV
• Daniel Bäde, Leipzig
• Christian Bahls, 1st Chairman MOGiS eV - a voice of reason (Association of victims of sexual violence in childhood)
• Dr. Michael Balke, judges in the 7th Senate Finance Court of Lower Saxony
• Dr. Waltraud Ballmer-Omar, Ruhr-University Bochum, Department of Psychology Cognitive Psychology GAFO
• Dr. med. Heidrun Baronowski, Zurich
• Dr. Max Bartel, Psychotherapist, Berlin
• Lawyer Matthias Bartel, Wiesbaden
• Dr. Jan Bartussek, neuroscientists, ETH Zurich, Switzerland
• Dr. rer. nat. Michael Basten, Dipl.-Psych., Psychotherapist, Hamburg
• Dr. Jens Bathmann, specialist in nuclear medicine, Freiburg
• Reinhard Bauerschmitz, Geographer, Wiesbaden
• Andrea Baumann, doctor, psycho-oncological care Skin Cancer Center, University Hospital Düsseldorf
• Dr. rer. nat. Andreas Beck, Berlin
• Heike Beck, MD, specialist in gynecology and obstetrics, Frankfurt / Main
• Dr. Joachim Becker, gynecologist
• Manfred Beckers, Dipl.-Phys., Dresden
• Lawyer Masoud Behraznia, Hamburg
• Prof. Dr. Hans Behrendt, Bielefeld
• Dr. Gisela Behrmann, Education and Ethics, retired, Potsdam
• Prof. John Bellmann, General Education, Westfälische Wilhelms-Universität Münster
• Prof. Dr. oec. HSG Oliver Bendel, University of Applied Sciences Northwestern Switzerland, School of Business, Institute of computer science, director competence focus on Digital Innovation & Learning (DIL)
• Wolfgang Benn, psychiatrist and psychotherapist, Weinheim / Bergstraße
• Dr. Wolfgang Bensch, specialist in orthopedics, Isny
• Gisela Bergmann-field mouse, psychologist and psychoanalyst, Danish Nienhof
• Dipl.-Psych. Best Dieter, Psychotherapist, National Chairman of the
German Association of Psychotherapists
• Hening Bettermann, school doctor retired, Oslo
• Dr. Gottfried Beyvers, specialist in occupational medicine, author, Landshut
• Dr. jur Peter Bezler, lawyer
• Lawyer Brigitta Biehl, Vice Chairman peri eV, Cologne
• Prof. Dr. theol. Reimund Bieringer, professor of New Testament exegesis, Catholic University of Leuven, Belgium
• Drs Ingrid and Wolfhard Bindeballe
• Dr.med. Gitta Binder Klinsing, physician general practitioner and psychosomatic medicine, psychotherapy, psychoanalysis, Frankfurt / M.
• Lawyer Alexander Beer, LL.M., King Winter
• Professor Mark Binz
• Dr. med Bisler, Sebastian, LVR-Klinikum
• Gerhard Bleckmann, children and young doctor, Baunatal
• Astrid Blumenstock, Attorney & Mediator, Food
• Dr. Frederick Bode, Former Undersecretary, Mönchengladbach
• Thomas Böhm, urologist, yard
• Jens Böhmer, Queen Silvia Children's Hospital, Sahlgrenska University, Gothenburg / Sweden
• Attorney Anna E. Boldt, Reinbek
• Dr. Ing. Arnold Bölkow, a specialist in internal medicine and diploma in electrical engineering, Hauzenberg
• PhD. Ralf Bönt
• Dr. Joachim Börner, wages
• Dr. Dietrich bosses, Leverkusen
• Dr. Hans-Werner Bouman
• Dr. Annegret Brauer, specialist in child and adolescent psychiatry and psychotherapy, Halle / Saale
• Prof. em. Dr. iur. John Brown, Passau
• Attorney Alexandra Brown, Hamburg
• Dr. Nico Breitbach-Faller, Consultant Child and Adolescent Medicine with emphasis pediatric neurology, director of the Social Paediatric Centre Esslingen, Children's Hospital
• Dr. Hans Breuninger, Ravensburg
• Priv. Prof. Dr. med Karl Heinz Brisch, Munich
• Dipl.-Psych. Waltraud Brecht, Psychotherapist, Backnang
• Dipl.-Psych. Ellen Broos-Marr, Bochum
• Dr. Carla Bruchhausen, radio log, Wiesbaden
• Dr. med. Klaus EF Brucker, Offenburg
• Dr. Klaus-Peter Bruck Mooser, anesthesiologist, Dr. Horst Schmidt Hospital, Wiesbaden
• Dipl.-Psych. Monika Brzoza, Psychotherapeutic Practice, Frankfurt
• Prof. Dr.-Ing. Joerg J. Buchholz
• Regine Buchold, doctor
• Dr.med.Wolfgang Bühmann, Consultant Urologist - Andrology Med.Tumortherapie - quality management, Westerland Sylt OT
• Dr. phil. Dipl.rer.pol. Joachim Bullinger MA, naturopaths for psychotherapy, Offenbach
• Retired Pastor Michael Buelow, Witten
• Christoph von Bülow, LL.M., Attorney at Law of the State of New York
• Georg citizens, Dipl.-Psych., Oldenburg
• Prof. Dr. Carsten Burstedde, Rheinische Friedrich-Wilhelms-University of Bonn
• Prof. Dr.-Ing. Fritz Büsching, Brunswick
• Carsten B. Caspers, Dipl Chem, Rommerskirchen
• Dr.rer soz Alessandro Cavicchioli, Psychotherapist, child and adolescent psychotherapist, lecturer and supervisor (DVT), Schwäbisch Hall
• Tomislav Chagall, Frankfurt
• Med pract. Homayon Reinhardt Chaudhry, Federal and FMH specialist in psychiatry and psychotherapy practitioner, Zurich
• Frank Christmann, Ph.D. in Philosophy and Ethics, St. Louis University, Dipl.-Betr.W., HTW Saarland
• Dr. onk. Maraijke Helga Claar, Kertváros Keszthely, Hungary
• Dr. Birgit Clever, chairman bvvp Federal Association of Psychotherapists contract
• Dr. Cornelius Courts, Department of Forensic Medicine, functional area of Forensic Genetics, University of Bonn
• Lawyer Norman Czoch, Oranienbaum-Wörlitz
• Dr. Ulrich Damerau, Gifhorn
• Carsten Dams, lawyer, Food
• Dr. Horst Christian Danner, specialist in anesthesiology, Kelheim
• Timo Deba, medical student, University of Witten / Herdecke
• Michael Degen, psychologist, psychoanalyst, psychotherapist Psycholgischer, child and adolescent psychotherapist, Cologne
• Eva Julia Dehl, dentist, Ratingen
• Dr. phil. Dipl.-Psych. Frank Roland Deister, Psychol psychotherapist, psychoanalyst, Frankfurt
• Norbert Denef, Chairman netzwerkB - Network and survivors of sexual violence eV
• Dr. Franz Lothar Deres DESA, anesthesiologist and pain management
• Carsten Dettbarn, Dipl.-Ing. (Univ)
• Prof. Dr. V. Patrick Dias (Dr. Theol., PhD, Dipl.-Psych., Professor Emeritus, Johann Wolfgang Goethe University Frankfurt am Main, Department of Education)
• Christian Dibbert; physician pediatric surgery; Schwerin
• Lawyer Bernd thickness Müllrose
• Andreas Dieckmann
• A. Diemand, Dr. rer. nat., agronomist and bioinformaticians, Schaffhausen
• Dr. Ralph Dietrich, surgeon, Munich
• Dr. Brigitte Dietz, practicing child and youth health care professional deputy. Chairman of the Professional Association of Child and Adolescent Physicians in Bavaria, Taufkirchen
• Prof. Dr. Dr. hc Hans Georg Dietz, Children Surgery, Dr. von Hauner Children's Hospital Sches, Hospital of the University of Munich
• Axel Dinslage, Psychologist, Psychotherapist, Bad Vilbel
• W.Dittrich, Dipl.-Psych. (Ret.), Düsseldorf
• Adem Dolas, Neurology, University Hospital Düsseldorf
• Dr. S. Raymond Dominguez, Augsburg
• Lutz Dondit, neuro pediatrician, neonatologist, clinic for children and adolescents, a member of the child protection team, Klinikum GmbH Esslingen
• Dr. Kai Dordelmann, general practitioner, Karlsruhe
• Elisabeth von Dorrien, top government and lecturer at the University of Koblenz, Andernach
• Lawyer Klaus W. Dörwald, Wolfertschwenden
• Henning Droege, General medicine, homeopathy, naturopathy, Waldenburg
• Dr. Ingo Dulisch, General Medicine, Karlsruhe
• Dr. phil. Benita von Eberstein, psychologist, Merzen
• Professor Dr. Theodor Ebert, Erlangen
• Dr. Klaus Eckhardt, M Oers
• Prof. Dr. theol. hab. Angelika M. Eckart, Department of Pastoral Psychology at the Faculty of Theology Vallenda
• Prof. Dr. theol. hab. Joachim Eckart, Philosophy and Theology Vallendar
• Thomas Eckelmann, a specialist in internal medicine, Oelsnitz iV
• Dr. Michael Eckstein, FA in internal medicine, sports medicine, emergency medicine, family doctor, Reilingen
• Prof. Dr. Ulrich Egle, Freiburg, Chairman of the Interdisciplinary Society for Psychosomatic Pain (IGPS)
• Dr. phil. Hans-Jörg Ehni, Deputy. Director, Institute for Ethics and History of Medicine, Tübingen
• Dr. Alexander Ehnis, Consultant Dermatology and Venereology, Lampertheim
• Lawyer Georg Ehrmann, CEO of Deutsche Kids Help
• Patrick O. Ehrmann, Chemist (University of Karlsruhe), Microsoft Certified Professional Sytemanalytiker
• Dr. Verena Ellerkamp, Specialist in Pediatric Surgery, University Hospital Tübingen
• Attorney Heiner end, Cologne
• Prof. Dr. phil. hab. Bernd Enders, musicologist, Osnabrück
• Dr. Gerhard Engelmayer Chairman freethinkers Confederation Austria
• Edgar E. Engesser, children, youth and family psychologist, Karlsruhe
• Martin heritage, doctor, Saarlouis
• Prof. Dr. Jeanette Erdmann, University of Lübeck
• Prof. Dr. Bernd Erichson
• Dr. Holger C. Erne, Munich
• Prof. Dr. rer. nat. Helmut Esche, Cologne
• Prof. Michael Falkenstein, Dipl.-Psych., Dipl.-Ing. Head of Project Group "Aging and CNS alterations", Leibniz-Institute for Industrial Research at the Technical University of Dortmund (IfADo), Dortmund
• Attorney Bernard J. Fassbender, Lecturer of Business Law at the University of Applied Sciences North-DIPLOMA Hesse
• Dr. Heidrun Fehling, Hamburg
• Professor Thomas J. Feuerstein, doctor of Pharmacology and Toxicology, Neurology and Psychiatry
• Dr. Christian Fiala, a specialist in gynecology and obstetrics, Vienna
• Graduate Jur Henry Figge, Law Clerk
• Egbert Finck, Specialist in Orthopaedics and Sports Medicine - Chiropractic - Acupuncture, inpatient and outpatient surgery, Sana Clinic Düsseldorf - Benrath practice of Orthopaedic Surgery, Düsseldorf
• Law Auditors Hanns-Erich Fink, Berlin
• Herwig Fischer, retired judges, Salzhemmendorf
• Helmut Fink, Nuremberg, Chair of the Humanist Association HVD Bavaria
• Dr. Monika Fierus, Leverkusen
• Dr. Hans Fischer, dermatologist, allergist, Dornstetten
• Dr. Peter Fischer, Arnstein
• Dr. Doris Fischer, Specialist Children's Hospital, Frankfurt / Main
• Peter Fleiner, vice-president of the Social Court, retired, Waldkirch
• Gabrielle Fleitmann, Dipl.Psych. & Doctor Heidelberg
• Dipl. Psych Michael B. Flöter, Psychotherapist / behavioral therapist, teacher contract Therapist kvno, member of the German Association of Psychotherapists, a member of the DVT, Cologne
• Graduate - Psych Regina Forberger, Bensheim
• Dr. Helmut Förster, Food
• Andrea Frank, doctor, assistant training in general medicine, Munich
• psychotherapist Konrad Franke, Frankfurt
• Prof. Dr. Matthias Franz Düsseldorf, Clinical Institute of Psychosomatic Medicine and Psychotherapy, University
• Prof. Dr. Berthold Franzen, course director engineering computer science, Institute of Engineering and computer science, department of mathematics, science and computer science, Technical University of Central Hesse
• Peter Paul Friday, a psychologist and psychotherapist, Nuremberg
• Dr. Dieter Freundlieb
• Prof. Dr. Ivar Friedrich, cardiothoracic surgeon, Trier
• Heike Friederichs, Specialist in Neurology and Psychiatry, Zurich
• Dr. med.dent. Fritz Berthold, specialist in orthodontics, court experts in local and district courts in NRW
• Dr. Fritz Berthold, Duisburg
• Dr.sc.nat. Manfred Fröde, Köthen
• MD, Thomas Fröhlich, pediatrician, doctor
• Jochen Gaedcke, biologist, Ettenheim
• Dr. med. Miriam Gaggl, Dielsdorf
• Manfred Galland, a specialist in neurology and psychiatry, psychotherapy, Horb
• Thomas Galos, MBA, Vienna
• Prof. Dr. iur. Ulrich M. Gassner, Mag rer. publ., M. Jur (Oxon.), University of Augsburg
Faculty of Law, Institute for Organic, Health and Medical Law (IBGM), Augsburg
• Dr.med Timm Guard doctor - psychotherapy, Nettetal
• Dipl.-Phys. Dr. rer. nat. Hans-Georg von Garßen, Höhenkirchen-Siegertsbrunn
• Prof. Dr. iur. Ulrich M. Gassner, Mag rer. publ., M. Jur (Oxon.), University of Augsburg,
Faculty of Law, Institute for Organic, Health and Medical Law (IBGM)
• Tobias Gauss, Consultant, Surgical Intensive Care Unit, Department of Anesthesia and Critical Care, Beaujon Hospital, University Hospital, Paris Nord Val de Seine
• Gabriele Gawlich, deputy chairman MOGiS V.
• Dr. Guido F. Gebauer, a psychologist, legal psychologist, Hanover
• Christian Gebel, for the Dortmund pirates
• Lawyer Ludwig Gemeinhardt, Food
• Daniela Gerstner, Qualified Social, emphasis clinical social work - psychotraumatology Berlin
• Franz Gescher, lawyer and notary, Berlin
• Dipl.Biol. Dr. Med Bernhard J.Giesguth, general practitioner, Mönchengladbach
• Lawyer Oliver Glaser, Cologne
• Dr. Martin fortunate children and young doctor, neonatal ambulance, Fritzlar
• Priv-Doz. Dr. Georg Göbel, biostatistician, Medical University Innsbruck, Austria
• Prof. Dr. Hartmut Goebel, a specialist in neurology, special pain therapy, psychotherapy, Kiel Pain Center
• Dr. sc. Tobias Goerdt, MSci, Departamento de Física Teorica, Universidad Autónoma de Madrid
• Daniel Goldberg, president of Children's Lobby Switzerland
• Claudia Goldner, Dipl.Päd.univ., Counseling Landshut
• Angelica Santana Gonzalez, graduate lawyer, trainee lawyer and mediator
• Dr. Sebastian GoB, medical assistant (anesthesia), Cologne
• Prof. Dr. med.vet. Rainer Gothe, a veterinary specialist in parasitology, veterinary DTVM for Tropical Veterinary Medicine (Edinburgh)
• Ass. Wolfgang Gourgé, Stade
• Prof. Dr. Dittmar Graf, biologist, University of Dortmund
• Prof. Dr. Oliver Grau, Danube University Krems
• Prof. Robert Greb, fertility centers Dortmund, Siegen, Dorsten MVZ, Dortmund
• Dr. Bernhard Greiling, specialist in internal medicine - gastroenterology, specialist in psychosomatic medicine and psychotherapy - psychoanalysis, Eutin
• Detlev Gretsch, a psychologist, Berlin
• Lawyer Christoph Grimm
• Prof. Helfried Dimension, former chief physician at the Children's Hospital in Nuremberg
• Dipl. Psych Gesa Groh, University Hospital of Munich, Dr. von Hauner Children's Hospital Sches
• Dr. Horst Gross, Anaesthetist and Intensive Care Medicine, Berlin
• Dr. Hans Peter Grunder, Specialist for Psychiatry, Zurich
• Tatjana Grützmann MA, Department of History, Philosophy and Ethics of Medicine
• Dr. Joachim Gubitz, Cologne
• Walter Gummersbach, Dipl.Psych, Dipl.Soz., Forensic Psychology, Berlin
• Dr. Helmut Günther
• Graduate Biochem. Jörg-Peter Gütlein, Beimerstetten
• Mag Olliver Haas, Independent Administrative Senate Vorarlberg Bregenz
• Attorney Dirk Stefan Haase, LL.M., Hamburg
• Dipl.-Psych. Gerhard Hafner, advice for men - violence, Berlin
• medical officer Dr. Rolf Hähnel, ophthalmologist, Neubrandenburg
• Dr. Walter Lorenz Hähnle, Hamburg
• Dr. phil. Walter Haider, a degree in education, Hochheim
• Maria U. Hammer, Dipl.-Psych., Psychotherapeutic Practice, Düsseldorf
• Prof. Dr. Klaus Hamper, wave
• Prof. Dr. iur. Bernhard Hard Tung, University of Rostock
• Norbert Hartkamp, specialist in psychosomatic medicine, psychoanalyst, practice for
Psychosomatic Medicine and Psychotherapy, Solingen
• Dr. Sabine Hartmann, Doctor of ENT, Speech Pathology and Audiology, Klinikum Dortmund
• Assia Maria Harwazinski, PhD., Islam and religious scholar, Tübingen
• Dr. Anh-Ha Thi Tam, ENT Specialist, Lüneburg
• Dr. Gunnar Hartung, FA f Neurology and Psychiatry / Psychotherapy, Chemnitz
• Dr. Robin Hau, Dipl.-Psych., Regensburg
• Dr. Hubertus Hautzel, Department of Nuclear Medicine (KME) ad site of the Forschungszentrum Jülich, Düsseldorf University Hospital
• Ulrich Hegemann, Dipl.-Psych, PP, Greven
• Dr. med Marcus Heidemann, Fachazt for Child and Adolescent Medicine, Bielefeld
• Prof. Dr. rer. nat. Eduard Heindl
• Frank Heinze, nurse, member of the clinical ethics consultation at the University Hospital Erlangen
• Priv-Doz. Dr. rer. nat. Juergen Henke, Neuss
• Dr. rer. nat. Dipl.-Biol. Alexander Henke, tumor biologist at the University Hospital of Cologne
• Ass Jur Dirk Henke, Dortmund
• Dr.med. Günter hen, Cologne
• Dr. jur. Gudrun Henne, lawyer and coach, Berlin
• Lawyer Kristof Henrich, Frankfurt
• Dr. Jochen Hentschel, lawyer, Cologne
• Hermann Herf, Director of Studies, Westfalenkolleg Bielefeld (establishment of the Second
Educational path), Bielefeld


• Rainer Herlitz, lawyer (member of the Düsseldorf Bar Association)
• Martina Herpich, running
• Dr. Mark Herpich, Berlin
• Professor, Doctor of Divinity. Horst Herrmann, University of Münster
• Prof. (emeritus) Dr. Rolf Dietrich Herzberg, Ruhr-Bochum Univerity
• Dr. Martin Heyse, Bad Wurzach
• Prof. Dr. Uwe Hillebrand, Wolfenbüttel
• Dr. GW Himmelmann, Hamburg
• Clemens Hirsing dentist
• Dr. Mathias Hirsch, a specialist psychiatric, psychotherapeutic medicine, psychoanalysis, Düsseldorf
• Dipl.Psych. Raimund Hirth, Birkenheide
• Carsten HOBBJE psychologist, psychotherapist, behavioral therapy, Quakenbrück
• Dr. phil. Fritz Erik Hoevels, Dipl.-Psych., Psychoanalyst, Freiburg iBr.
• Dr. Albrecht court Aalen
• Attorney Stephan Hoff, Frankfurt (Oder)
• Dr. Moritz Hoffmann
• Ass. Andreas Hofmann, Senior Research Fellow, Faculty of Law, University of Bayreuth
• Dr. Andreas Hofmann, Karlsruhe
• Dr. Johanna Holldack
• Prof. Dr. Walter Hollstein, Berlin / Basel
• Ulrike Hopf, senior public prosecutor, retired, Brunswick
• Dr. Gereon Hoppenkamps, occupational medicine, psychosomatic medicine, psychoanalysis (DGPT, DPV, IPV), Cologne
• Dipl.-Psych. Kordula Horstmann, Psychotherapist, Bohmte
• Dr. Oliver hoof, specialist in internal medicine / cardiology, Kaiserslautern
• Dr. Werner Paul Hürzeler stone
• Stefanie Immler, Dr. von Hauner Children's Hospital Munich Sches
• Dr. Robert Ivancic, physician for Neurology, Psychiatry, Augsburg
• Associate Professor Dr. med. Renate Jahn, MD
• Dr.med. Kornelia Jahn, Specialist in Obstetrics and Gynecology, Bad Wildungen
• Prof. Paul L. Janssen, Bochum
• Dr. Ludwig Janus, Heidelberg
• Felicitas Jendral, Fachärztin für Allgemeinmedizin, Dresden
• Prof. Dr. rer.nat. Dieter Jendrossek, Universität Stuttgart
• Professor Dr. iur. Dr. phil. Dr. iur. hc Günter Jerouschek MA, Lehrstuhl für Strafrecht, Strafprozessrecht und Geschichte des Strafrechts an der Friedrich-Schiller-Universität Jena; Appr. Psychotherapeut, Psychoanalytiker (DPV, IPV)
• Rechtsanwalt Heiko Jörges, Berlin
• Christoph Jovy, FA f. Pschychotherapie u. Psychosom. Medizin, Freiburg
• Angelika Jung, Diplom-Psychologin, Psychologische Psychotherapeutin,
Praxis für Psychotherapie, Bramsche
• Dipl.-Wirtschaftsinformatiker Andreas Jung, Fachhochschule Schmalkalden
• Rechtsanwalt Klaus Jung, Wettenberg
• Prof. Dr. Klaus Junker, Institut für Klassische Archäologie, Johannes Gutenberg-Universität Mainz
• Dr. Dr. Joachim Kahl, Philosoph, Marburg
• Dr. med. Bita Kahlen, Universitätsklinikum Mainz
• Dr. med. Jan Kahrs, FA Allgemeinmedizin, Twist
• Prof. Dr. Jochen Kaiser, Direktor des Instituts für Medizinische Psychologie. Goethe University Frankfurt am Main
• Sebastian Guevara Kamm, Arzt, Promoviert in der Kinder und Jugendpsychosomatik der Universität Gießen Marburg, Stellv. Vorsitz des Vereins KroKi für chronisch kranke Kinder eV
• Dr. jur. Heinz Kammeier, Münster
• Dr. med. Wolfgang Kämmerer
• Dr. med. Thomas Kanthak, Urologisches Facharztzentrum Wetzlar
• Andre Karger
• Dipl.-Psych. Angela Kartschall, Praxis für Psychotherapie, Busdorf
• Dr. med. Ricarda Kauert, FÄ für Psychosomatische Medizin und Psychotherapie, Wuppertal
• Gary Kaufhold, Dipl.Psych, Psycho-Analytiker, Glücksburg
• Karl-Heinz Keil, Riemerling
• Dipl.- Psych. Dr. Udo Keil, Darmstadt
• Dipl. Soz.-Wiss. (Soziale Arbeit und Erziehung), Dipl. Soz.-Wiss. ( Soziologie) Studienrat Peter Kelm, Krefeld
• Christian Kemper, Zahnarztpraxis, Hamburg
• Wolfgang Kemperdick (Dipl.Psych.), Psychologischer Psychotherapeut, Kinder- u. Jugendlichenpsychotherapeut, Soest
• Prof. Dr. Waltraut Kerber-Ganse, Psychologie/Erziehungswissenschaft, pensioniert, ehemals Technische Universität Berlin
• Nicolaus Kern, Assessor jur., Mitglied des Landtags NRW – Piratenfraktion
• Dr. med Norbert Ketteler, Facharzt für Allgemeinmedizin, Bottrop
• Dr. Wolfgang M. Kieninger, Arzt f. Kinder u. Jugendliche, Meckenbeuren
• Dr. med. Michael Kirsch, Facharzt für Neurologie und Psychiatrie
Psychotherapie, Psychoanalyse, Dresden
• Ingo-Wolf Kittel, Facharzt für Psychotherapeutische Medizin, Philosophische und Psychotherapeutische Praxis, Augsburg
• Dr. med. Peter Klare, FA. Gynäkologie und Geburtshilfe, SP Gynäkologische Onkologie, SP Reproduktionsmedizin und gynäkologische Endokrinologie, Berlin
• Prof. Dr. med. Johannes Klein, Zentrum Endokrine Medizin, Lübeck
• Dr. phil. Richard Klein, Horben
• Dr. med. Mathias Klemme, LMU München, Klinikum Großhadern, Neonatologie, Facharzt für Kinderheilkunde
• Dr. med. Mechthild Klingenburg-Vogel, Fachärztin für Psychotherapeutische Medizin – Psychoanalyse, Kiel
• Dr. med. Hartmut Klink, Künzelsau
• Dr. rer. nat. Wolfgang Klosterhalfen, Prof. für Medizinische Psychologie (nicht mehr aktiv)
• Oliver Kloth, Rechtsanwalt, Fachanwalt für Familienrecht, Teningen
• Dr. med. Christian Knobloch, Medical Consulting, Pharma - Biotech – Healthcare, Berlin
• Dr. med. Michael Knoch, Kindergarten- und Schularzt, FWS Kreuzberg, Berlin
• Dr. Wolfgang Köbele, Anger
• Dr. phil. Marion Koch, Sozialwissenschaftlerin, Bielefeld
• Dr. med. Veit Koch, Arzt für Allgemeinmedizin - Flugmedizin – Betriebsmedizin, Bühl-Vimbuch
• Andreas Koch, Dr.sc.nat. ETH, Hombrechtikon, Schweiz
• Professor Georgy Koentges, PhD, Laboratory of Systems Biomedicine and Evolution, School of Life Sciences, University of Warwick, Coventry, UK
• Dr. Albrecht Köhl, FA für Psychosomatische Medizin und Psychotherapie, FA für Innere Medizin – Psychoanalyse, Wetzlar
• Dr. Bruno Köhler, Vorstandsvorsitzender MaNNdat eV - Geschlechterpolitische Initiative
• Diplom Biologe Joachim Köhne, Berlin
• Dipl.-Psych. Andreas Köhnke, Kinder- und Jugendlichenpsychotherapeut, Hamburg
• Dr. med. Karsten König, Internist, Damme
• Ralf Konnopke, Diplom Sozialpädagoge/Sozialarbeiter(FH), Systemischer Therapeut und Familientherapeut(DGSF), Traumapädagogik und Traumazentrierte Fachberatung (DeGPT)
• Dr. med. Ulrike Koock, Prüfärztin in klinischen Studien sowie Assistenzärztin im Fachbereich Onkologie, Krankenhaus Nordwest in Frankfurt/Main
• Dr. med. Ursula Kouba, Oberstdorf
• Univ.-Prof. Dr. Klaus Kraemer, Institut für Soziologie, Universität Graz, Österreich
• Dipl.-Phys. OStR Torsten Krallmann, Burgdorf
• Dr. med. Sebastian Kramberg, Denkendorf
• Prof. Dr. Lothar Krappmann, UN-Ausschuss für die Rechte des Kindes (2003-2011)
• Hartmut Krauss, Sozialwissenschaftler, Gesellschaft für wissenschaftliche Aufklärung und Menschenrechte (GAM)
• Dr. rer. pol. Andreas Kraußer, MANNdat eV
• Dipl.-Ing. Matthias Krönert, Gransee
• Dipl. Psych. Stefan Krug, Georgsmarienhütte
• Stefanie Krumsdorf, Assistenzärztin Kinderchirurgie, Universitätsklinikum Jena
• Dr. Heinz-Werner Kubitza, Verleger, Tectum Wissenschaftsverlag, Marburg
• Anca Kübler, Rechtsanwältin und Opferschutzanwältin, Dresden
• Dr. med. Jochen Kuhl, Facharzt für Innere Medizin-Kardiologie, Gemeinschaftspraxis für Herz- und Kreislaufkrankheiten, Bonn
• Horst Kuhli, MA, Mag.theol., Dipl.-Pol., Dipl.-Päd., Pfarrer iR (Nidderau)
• Dr. med. Hans- Georg Kühn, Internist und Proktologe, Berlin
• Gisela Kühn, FÄ Kinder- und Jugendmedizin, Berlin
• Dr. rer. nat biol. Uwe Kullnick, Neurophysiologe
• Dr. Gunther Kümel, Virologe, Kelkheim
• Tobias Kutschinski, Rechtsanwalt, Bremen
• Dr. Stefan Laarmann - Arzt für Chirurgie, Arzt für Urologie
• Dr. Ingeborg Lackinger Karger, Psychoanalytikerin und Frauenärztin, Autorin, Düsseldorf
• Dr. med. Hans-Dieter Lang, Facharzt für Innere Medizin iR, Kiel
• Dipl.-Psych. Fredi Lang MPH, Berlin
• Walid Laschin, MA
• Ulrich Lasse, Diplom-Psychologe, Erziehungsberatungtellenleiter im Ruhestand
• Dipl.-Ing. Wolfgang Lau-Bomert, Kassel
• Frau Corinna Laureys, Dipl.-Heilpädagogin, Familientherapeutin, SAFE-Mentorin
• Martina Leber, Psychoanalytikerin, Frankfurt
• Dr. med. Hanjo Lehmann, Berlin
• Tornalf Lehmann, Facharzt für Innere Medizin, Dietenhofen
• Dirk W. Lehmann, Arzt für Anästhesiologie, Köln
• Jochen Lehmann, Ass. iur. und Promovent, Düsseldorf
• Prof. Dr. Ulrike Lehmkuhl, Charité - Universitätsmedizin Berlin
• Prof. Dr. Gerd Lehmkuhl, Universität Köln
• Gerd-Elmer Lennartz , Facharzt für Neurologie und Psychiatrie , Psychotherapie , Suchtmedizin, Weingarten
• Dr. Manon Letzelter, Zahnärztin, Trier
• Prof. Dr. Anne Levin, Allgemeine Didaktik und Empirische Unterrichtsforschung, Universität Bremen
• Mathias Lexis, Diplom-Psychologe, Psychologischer Psychotherapeut, Speyer
• Sema Ley, Diplom-Psychologin und Psychologische Psychotherapeutin, München
• Prof. Dr. Manfred Liebel, European Master in Childhood Studies and Children's Rights (EMCR) an der FU Berlin
• Prof. Dr. med. Klaus Lieberz, Mannheim
• Dipl.info. Dipl. pol. Jürgen Liminski, Publizist, Moderator beim Deutschlandfunk, GF des Instituts für Demographie, Allgemeinwohl, Familie ev
• Dr. rer. nat. Matthias Lipinski, Poughkeepsie, NY
• Dr. med. Ignatius vd Lippe, Augenarzt, Neustadt an der Orla
• Christine Lipp-Peetz, Diplom-Pädagogin, Dozentin an der Pädagogischen Akademie Elisabethenstift, Darmstadt
• Dr.med. Gottfried Lobeck, Dresden
• Prof. Dr.med. Volker v. Loewenich, Kinder- und Jugendarzt, Frankfurt aM
• Dr.med. Katharina v. Loewenich, Frauenärztin, Frankfurt aM
• Dipl.Psych. Gisela Loh-Dietrich, Mainz
• Dr. Fiona Lorenz
• Olde Lorenzen, Volljurist, Sydney
• Dr. Silke Lüder, Fachärztin für Allgemeinmedizin, Hamburg
• Priv.-Doz. Dr. med. Karl Ludwig, Chefarzt Radiologie, Herford
• Dr. Patrick HM Maas, Frankfurt am Main
• Gabriele Mahro, Verwaltungsjuristin, Bremen
• Prof. Dr. rer.nat. Bernd Mahro, Hochschullehrer, Bremen
• Ass. jur. Hans Maier, Buseck
• Rechtsanwalt Dr. Daniel Maier, Stuttgart
• Prof. Dr. med. Friedrich Manz, Kinderarzt, Dortmund
• Frau Irmgard Manz, Analytische Kinder- und Jugendlichen-Psychotherapeutin, Dortmund
• Prof. Dr. Jürgen Marenbach, Psychoanalytiker, Düsseldorf
• Rechtsanwalt Armand Maréchal, Frankfurt/M.
• Marcus Marquardt, praktischer Arzt, London
• Rechtsanwalt Andreas Marx, Königstein im Taunus
• Dipl.-Volkswirt Udo von Massenbach, President American German Business Club Berlin eV
• Dipl.-Psych. Frank Massow, Psychologischer Psychotherapeut, Kinder- und Jugendlichenpsychotherapeut, Chemnitz
• Dr. med. Benedikt Matenaer, Facharzt für Anästhesie, Spezielle Schmerztherapie, Palliativmedizin, Bocholt
• Prof. Dr. Kosta Mathey, GLOBUS Global Urban Studies Institute International Academy at FU Berlin
• Dr. jur. Milosz Matuschek, Berlin
• Dr. Eugen Maus, Diplom-Psychologe, Mitbegründer und langjähriger Vorsitzender von „MANNdat e. V., Frankenthal
• Prof. Dr. Rainer Mausfeld, Institut für Psychologie, Universität Kiel
• Dr. rer. nat. Ekkehard May, Dipl. Biol.
• Wolfram Meier-Stuckenberger, Leitender Ministerialrat aD im bayerischen Gesundheitsministerium
• Günther Meinel, Europabüro Diplomaten International
• Rechtsanwältin Julia Meinken, Hamburg
• Dr. Wolfgang Meinrenken, Arzt für Kinder und Jugendmedizin, Bremen
• Dr. med. Michael L. Meiser, Facharzt für Innere Medizin und Arbeitsmedizin, Hamburg
• Klaus Menne, Diplom-Soziologe und Geschäftsführer, Bubenreuth
• Dr. Grischa Merkel, Wissenschaftliche Mitarbeiterin, Lehrstuhl für Strafrecht, Strafprozessrecht und strafrechtliche Nebengebiete, Juristische Fakultät, Universität Rostock
• Prof. Dr.Peter Meusers, Esssen
• Dr. med. Frank Meyer, Facharzt für Psychiatrie und Psychotherapie, Klinik für Forensische Psychiatrie und Psychotherapie Weissenau, Leitung Forensische Ambulanz, ZfP Südwürttemberg
• Dr. med. Ursula Meyer, Fachärztin für Psychosomatische Medizin und Psychotherapie, Ravensburg
• Dr.med. Anja Meyer, Fachärztin HNO, Ravensburg
• Dr. Christopher Michaelsen, Senior Lecturer, Faculty of Law, University of New South Wales, Sydney NSW 2052, Australia
• Hugo Mildenberger, Arzt, Grünberg
• Prof. Dr. Petra Mischnick, Wolfenbüttel
• Dr. Kai Moeller, Lecturer in Human Rights Law, Law Department, London School of Economics and Political Science
• Dr. Christina Morina, PhD, Lehrstuhl für Neuere und Neueste Geschichte, Friedrich-Schiller-Universität Jena
• Dipl. Psych. Simone Mosch, Psychotherapeutin, wissenschaftliche Assistentin am Lehrstuhl für klinische Psychologie, Psychotherapie und Psychoanalyse, Zürich
• Dipl.-Phys. Mag. rer. nat. Roland Mross, Dietach, Österreich
• Dr. med. Frank Muenster, Verden
• Dr. med. Thomas Gerd Müller, Facharzt für Kinder- und Jugendmedizin, Martin-Luther-Universität Halle – Wittenberg
• Dr. Jörg Müller, Augenarzt, Gera
• Dr. Sabine Müller, Charité - Universitätsmedizin Berlin
• Prof. Dr. rer. nat. Dietrich O. Müller, Berlin
• Dr. Wolfgang Philipp Müller, Verleger
• Dr. med. Helmut Müller, Urologe, Oberarzt am Klinikum Deggendorf, 1. Vorsitzender des Ärztlichen Bezirksverbandes Niederbayern (KdÖR), Vorstandsmitglied der Bayer. Landesärztekammer, Bernried
• Dr. Karl Müller-Bruckschwaiger, Arzt und Zahnarzt, Zwettl, Österreich
• Eva Müller-Grathoff, Diplom Psychologin, Rennerod
• Dr. Jonas Müller-Hübenthal, Facharzt für diagnostische Radiologie und Nuklearmedizin, Köln
• Diplom-Psychologin Andrea Müller-Mann, Olgahospital Stuttgart, Sozialpädiatrisches Zentrum
• Prof. Dr. Jochen Musch, Universität Düsseldorf
• Simone Muth, Diplom-Sozialarbeiterin, Dernau
• Andreas Henning Nauenburg, Ltd. Oberarzt, Abt. f. Radiologie und Nuklearmedizin, Sana Hanseklinikum Wismar GmbH
• Dipl.-Phys. Dr. rer. nat. Arno Neidig
• Friedrich Neitscher
• Christian Nelles, Internist und Kardiologe, Karlsruhe
• Dr. med. Lars Nelleßen, Facharzt für Kinder- und Jugendmedizin -Sportmedizin-, Kassel
• Dr. med. Heide Nespital, Allgemeinmedizin/Sozialmedizin, Leitende Medizinaldirektorin aD
• Dr. Eva Neumann, Diplom-Psychologin, Wissenschaftliche Mitarbeiterin, Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Abteilung für Psychosomatische Medizin und Psychotherapie
• Prof. Dr. Ing. Dietrich Neumann, Architekturhistoriker, Brown University, Providence, RI USA
• Dr. med. Gregor Nietgen, Augenarzt, Ulm
• Dr. med. Thomas Noll, Facharzt für Allgemeinmedizin, Enger
• Dr. Stephan Heinrich Nolte, Kinder- und Jugendarzt,Neonatologie-Psychotherapie-Homöopathie-Palliativmedizin, Lehrbeauftragter der Philipps-Universität Marburg, Bezirksobmann Marburg des Berufsverbandes der Kinder- und Jugendärzte
• Dr. med. Ulrich Onken, Burgebrach
• Kirsten Offermanns, Rechtsanwältin, Wiesbaden
• M.Sc. Dipl.-Ing. Christian Olt, Frankfurt
• Dr. Gerlinde Opel, niedergelassene Fachärztin für Dermatologie, München
• Wolfram Ortlieb, Facharzt für Orthopädie, Trier
• Walter Otte, Rechtsanwalt, Berlin
• Rechtsanwalt Dr. Oliver Panetta, Hannover
• Eerke Pannenborg, LL.M., Wissenschaftlicher Mitarbeiter am Lehrstuhl für Strafrecht, Wirtschaftsstrafrecht und Strafprozessrecht der Universität Osnabrück
• Prof. Dr. med. Mechthild Papousek, im Ruhestand, ehemals Leiterin der Forschungs- und Beratungsstelle „Frühentwicklung und Kommunikation“ am Institut für Soziale Pädiatrie, LMU München
• Dr. Willibald Pateter, Steiermärkische Krankenanstaltenges.mbH, LKH - Univ. Klinikum Graz Bereich Recht und Beschwerden, Graz
• Sandra Pauen Dipl. Sozialpädagogin, systemische Familienberatung Neuss
• Prof. Dr. Ulrike Petermann, Lehrstuhl Klinische Kinderpsychologie, Zentrum für Klinische Psychologie und Rehabilitation, Bremen
• ref. iur. Johannes Peters, Wissenschaftlicher Mitarbeiter am Lehrstuhl für Strafrecht, Strafprozeßrecht und Geschichte des Strafrechts von Prof. Dr. Dr. Dr. hc Günter Jerouschek der Friedrich-Schiller-Universität Jena
• Dr. med. Jörg Peters, Bundeswehrzentralkrankenhaus Koblenz
• Dr. med. Susanna Peters, Internistin, Hamburg
• Dirk Petsch, Dipl.-Politologe, Tönning
• Dr.Erich Pillwein, Präsident der Bundeszahnärztekammer aD
• Dipl. Phil. Helena Piprek, Kooperationspartnerin der Europäischen Kommission, Projektpartnerin für das Europäische Parlament, HUB Humboldt-Universität zu Berlin , Beeidigte Urkundenübersetzerin für die polnische Sprache, Hamburg
• Dr. med. Christine Pirschel, Augenärztin, Salzwedel
• Dr. med. Dirk Pirschel, HNO-Arzt , Salzwedel
• Prof. Dr. med. Martin Pfohl, Chefarzt der Klinik für Allgemeine Innere Medizin, Diabetologie und Endokrinologie, Mitglied der Ethikkommission der Ärztekammer Nordrhein, Evangelisches Krankenhaus BETHESDA zu Duisburg GmbH, Akad. Lehrkrankenhaus der Heinrich-Heine-Universität Düsseldorf
• Tom Philipp, Mitglied des Vorstandes B'90/GRÜNE Kreisverband Minden-Lübbecke
• Diplom-Psychologe Winfried Pohl, Tübingen
• Dr. Rigbert Polaczek, FA für Neurologie und Psychiatrie iR, Innsbruck
• Rechtsanwältin Martina Poll
• Sabine Ponader, Dr. rer. nat., Universitätsklinikum Köln
• Dipl.-Ing. (FH) Gabriele Pöndl, Klinische Kunsttherapeutin, HP-Psychotherapie, Wissenschaftsjournalistin (DJV), Uttenweiler
• Udo Porsch, PD Dr. phil. et med. habil. Dipl.-Psych., Mainz
• Dipl.-Psych. Regine Posé, psychologische Psychotherapeutin, Köln
• Ingrid Prassel, Fachärztin für Psychosomatische Medizin und Psychotherapie, Psychoanalytikerin, Köln
• Dr. Peter J. Preusse, Zahnarzt, Marburg
• Dr. med. Bernhard Puppe, Güntersleben
• Prof. Dr. Holm Putzke, Universität Passau
• Prof. Dr. med. Hartmut Radebold, Psychoanalytiker, Kassel
• Dipl.-Psych. Manfred Radau, Psychotherapeutische Praxis, Münster
• Rechtsanwalt Markus Rainer, Gröbenzell
• PD Dr. Dr.med. Rainer Rahn, Frankfurt/Main
• Dipl. Soz-Päd. Christina Ralfs, Essen
• Jan Raming LL.M. (Auckland), Rechtsreferendar Berlin.
• Andreas Rammelmeyer, Richter i. R., Darmstadt
• Prof. Dietrich Ratzke, Wehrheim
• Wolfram Rechbauer, Diplom-Psychologe, Psychotherapeut und Kinder- und Jugendlichen-Psychotherapeut, Kaiserslautern
• Eugen Rehm, Arzt für Allgemeinmedizin i. R., Königseggwald
• Ass. Iur. Sascha Rehberg, Berlin
• Dr. med. Dr. med. dent. Johannes Reichwein, Biebertal
• Dr. med. Jung Reiermann, Fachärztin für Innere Medizin und Nuklearmedizin, Mainz-Kastel
• Dr. med. vet. Eckart Reif, Böbingen
• Christian Rein, Facharzt für Kinder- und Jugendmedizin, Haßfurt
• Dr. med. Andreas Reuland, Schriesheim
• Dr. med. Brigitte Reuther, FÄ Allgemeinmedizin, Bad Waldsee
• Dr. med. Ralph-M. Reuther, Facharzt für Allgemeinmedizin, Bad Waldsee
• Dr. Sabine Reyer, Hamburg
• Jörg Richert, Geschäftsführung KARUNA Zukunft für Kinder und Jugendliche in Not eV
• Dr. Ina Richter, Rechtsanwältin, Dresden
• Dr. rer. nat. Falk Richter, Dipl.-Psych., Dresden
• Silke Richter, Diplom-Psychologin, Kinder- und Jugendpsychotherapeutin, Sozialpädiatrisches Zentrum SPZ, Klinikum Esslingen GmbH
• Dr. med. Christoph Richtmann, FA f. Anästhesie/Notfallmedizin, Ulm
• Maria Riehemann, Dipl. Theologin, Dipl. Religionspädagogin, Meppen
• Dr. Henrike Rieken
• Jürgen Riemer MA, Diplom-Sozialpädagoge, Universitätsklinikum Düsseldorf
• Dr. Michael Riess, Facharzt für Innere Medizin, Pneumologie, Kassel
• Dr. med. Ripkens, Augenarzt, Ravensburg
• Dr.med. Lutz Rohde, FA f. Chirurgie/Unfallchirurgie, Halle
• Prof. Dr. jur. Fredrik Roggan, Berlin
• Phillip Rogge, Stv. Sprecher des Arbeitskreises kinderchirurgischer Assistenten (AkA) in der Deutschen Gesellschaft für Kinderchirurgie (DGKCH)
• Dr. rer. nat. Arne Röhrs, Hilgermissen
• Dipl. psych. Walter Rokita, psychologischer Psychotherapeut
• DP Grit Ronneburg, Psychologische Psychotherapeutin, Jena
• Dr. med. Stephan Rose, Privat- und Gutachtenpraxis, Facharzt für Psychiatrie und Psychotherapie, Suchtmedizinische Grundversorgung, Facharzt für Anästhesiologie, Notfallmedizin, Segnitz
• Dr. Rainer Rosenzweig, Nürnberg
• Prof. Dr. iur. Dieter Rössner, Universitätsprofessor i. R., Institut für Kriminalwissenschaften der Philipps-Universität Marburg
• Dr. Hans-Jörg Rotberg, Rechtsanwalt, Bundesrepublik Deutschland
• Dr. jur. Gerald Roth, Karlsruhe
• Dr. Med. H.-M. Rothe, Facharzt für Innere Medizin, Facharzt für Psychosomatische Medizin, Görlitz
• Dr. med. Elisabeth Rowe, Berlin
• Dr. Michel Royeck, Neurowissenschaftler, Uniklinik Bonn
• Dr. med. Johannes Rudnick, Gießen
• Dipl.-Psych. Sebastian Rühl, Linsengericht
• Dr. iur. Joachim Rumpf - Rechtsanwalt -, München
• Britta Ruppert, Ärztin für Kinder- und Jugendpsychiatrie und –psychotherapie, Essen
• Dr. med. Frank Rußbild, Facharzt für Kinder- und Jugendmedizin – Neuropädiatrie, Münster
• Dr. med. Heino Rutner, Chirurg, Chefarzt iR, Schlüchtern
• Gerd-Reiner Sambale, Rechtsanwalt, Bremen
• Dr. med. Robert Sarhatlic-Voegtle, Freiburg
• Viktor Sarrazin
• Christoph Sauer, Pfarrer Stein SG, Schweiz
• Rechtsanwalt Wolfram Schaalo, Singen
• Cand. jur. Henrik Schacht, Europäischer Gerichtshof, Luxemburg
• Dierk Schäfer, Diplom-Psychologe, Diplom-Theologe, Pfarrer iR, Kinderrechtepreis-Träger, Bad Boll
• Dr. med. Mattias Schäfer, Facharzt für Kinderchirurgie, Abteilung für Kinderchirurgie und –urologie, Cnopf'sche Kinderklinik, Nürnberg
• Helmut Schallock, Notar, Nürnberg, stellvertretender Landesvorsitzender der Liberalen Senioren Bayern
• Dr. Octavian Schatz
• Dr. med. Thomas G. Schätzler, Facharzt für Allgemeinmedizin, Dortmund
• Prof. Dr. Henning Schauenburg, Universitätsklinikum Heidelberg, Klinik für Allgemeine Innere Medizin und Psychosomatik
• Dr. Dr. Bernd Scheibe, Neusäß
• Privatdozent Dr. iur. Jörg Scheinfeld, Mainz
• Rechtsanwalt Georg Schepper, Bielefeld
• Prof. Dr. med. Wolfram Scheurlen, Leitender Chefarzt der Cnopf´schen Kinderklinik, Nürnberg
• Dr. phil. Bernd Schick, Diplom-Psychologe, Psychologischer Psychotherapeut, Klinischer Hypnotherapeut (DGH), Gelnhausen
• Dirk Schieck (Dipl. Soz.-Arb.), Analytischer Kinder- und Jugendlichenpsychotherapeut, Trauma-Psychotherapeut (EMDR)
• Markus Schindler, Diplom-Psychologe, Wesseling
• Dipl.-Soz. Robert Schlack, Robert Koch-Institut, Berlin; Abteilung für Epidemiologie und Gesundheitsberichterstattung
• Dr. Matthias Schlick, Arzt für Innere Medizin – Kardiologie, Karlsruhe
• Dr. med. Christa Schlierf, FA für Innere Medizin, Psychotherapie und Psychosomatik, • Psychoanalytikerin DPV/IPV, Frankfurt a.Main
• Dr. med. Michael Schmelz, Oberarzt, Universitätsspital Basel, Klinik für Traumatologie, Behandlungszentrum Bewegungsapparat
• Dipl.-Psych. Regine Schmelzer, Klinisches Institut für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Düsseldorf
• Dr. med. Armin M. Schmidt, Mülheim/Ruhr
• Prof. Dr. Peter Schmidt aD
• Prof. Dr. Dr. Jens Schmidt aD
• Klaus Schmidt, Pfarrer i. R./ Historiker, Köln
• Dr. phil Eckhard Schmidt MA
• Dr. med. Rolf Schmidt, Hamburg
• Dr.med. Karl Rudolf Schmidt, Seefeld
• Dr. Christoph Schmid-Tannwald, Assistent des Instituts für klinische Radiologie an der LMU München
• Dr. phil. Michael Schmidt-Salomon, Philosoph, Vorstandssprecher der Giordano-Bruno-Stiftung
• Dr. med. Klaus Schmid-Ullrich, FA für Orthopädie, Freiburg
• Heinz Helfried Schmiedhofer, Dipl. Päd., Judenburg, Österreich
• Dr. Norbert M. Schmitz, Verlagslektor, Duisburg
• Hans Schmitz, Psychoanalytiker (DPG/DGPT), Brühl
• Reinhold Schneider, Diplom-Psychologe, Düsseldorf
• Detlev Schneider, Kulturwissenschaftler, Berlin
• Dr. Ansgar Schneider, Max-Planck-Institut für Mathematik, Bonn
• Dipl.-Psych. Elisabeth Schneider-Reinsch, Psychologische Psychotherapeutin (Verhaltenstherapie), Wiesbaden
• Prof. Dr. med. habil. Thomas Scholbach, Chefarzt, Klinik für Kinder und Jugendmedizin Chemnitz
• Dr. med. Karl-Heinz Schöter, Facharzt für klinische Pharmakologie, Erbes-Büdesheim
• Dipl. Volksw. Silvia Schöter, Erbes-Büdesheim
• Dr. med. Uta Schramm, Berlin
• Dr. Dr. med. Jan-Uwe Schreiber, Facharzt für Anästhesiologie, spezielle Intensivmedizin, Notfallmedizin, Aachen
• Dr. med. Matthias Schreiber, Kinderchirurg, Schwerpunkt Kinderurologie, Erlangen – Esslingen
• Marion Schrezenmaier, Rechtsanwältin, Hürth
• Dr. Alfred Schröcker, Wunstorf
• Dr. Rolf Schröder, Hamburg
• Holger Schröder, Jurist, München
• Priv.-Doz. Dr. Eberhard Schröder, Universität Potsdam, Department Psychologie
• Till Schuller, Dipl. Sozialarbeiter/ Sozialpädagoge, European Master in Childhood Studies and Children's Rights an der Freien Universität zu Berlin
• Dr. iur. Bernd Schulte, wiss. Referent, München
• Prof. Dr. med. Ulrich Schultz-Venrath, Klinik für Psychiatrie, Psychotherapie und Psychosomatik EVK Bergisch Gladbach, Kooperationsklinik der Universität Witten/Herdecke
• Dr. Herbert Schultz-Gora, Facharzt Psychosomatische Medizin,Psychotherapie – Psychoanalyse, Hofheim a. Ts
• Dr. Christian Schulz MSc, Stellv. Leiter des Zentrums Interdisziplinäres Zentrum für Palliativmedizin (IZP, Universitätsklinikum Düsseldorf
• Julia Schulz, MA, Universität Leipzig
• Thomas Schulz-Spirohn, Staatsanwalt, Berlin
• Dr. med. Richard Schütte, Remagen
• Rechtsanwalt Andreas Schwartmann, Köln
• Ass.-Prof. Dr. Peter Schwarzenegger, Universität Graz
• Eva Schweitzer-Köhn, Psychologische Psychotherapeutin, Bundesvorsitzende im Verband Psychologischer Psychotherapeutinnen und Psychotherapeuten im BDP eV, Berlin
• Wolfgang Schwenn, Dipl.-Psych., Psychologischer Psychotherapeut, Berlin
• Susanne Schwirske, Krankenschwester und Ergotherapeutin
• Manfred Michael Schwirske, Sozialwissenschafter
• Dipl. Psych. Ute Schwittek, Psychologische Psychotherapeutin, Bochum
• Dr. Rolf Seel
• Prof. Dr. Hans Reinhard Seeliger, Lehrstuhl für Alte Kirchengeschichte, Patrologie und Christliche Archäologie, Kath.-Theologische Fakultät, Eberhard Karls-Universität Tübingen
• Prof. Dr. Rüdiger Seitz, Universitätsklinik Düsseldorf
• Olaf Sens, Arzt für Allgemeinmedizin
• Dipl.-Psych. Constantin Sieg, Psychologischer Psychotherapeut, Bad Hersfeld
• Wolfgang Sigel, HNO-Arzt, Wedel
• Guy Sinden, www.beschneidung-von-jungen.de
• Dr. phil. Sabine Skutta, Diplompsychologin, Berlin
• Dr. Robert Söll, Chefarzt Anästhesie, Krankenhaus Tirschenreuth
• Rose Walsh Spaniol, USA
• Dr. Joseph Specht, Nussloch
• PD Dr. med. Tilmann Spieker, Pathologe, Universität Münster
• Dr. med. Ina H. Sprenger, Fachärztin für Psychiatrie und Psychotherapie, Schwelm
• Anne Springer, Ärztin, Mecklenburg-Vorpommern
• Kristian-Peter Stange, Diplomaten International
• Dr.med.Karlheinz Staudacher
• Dr. med. Hans-Jürgen Staudt, Arzt für Allgemeinmedizin, Kleinostheim
• Prof. Dr. Maximilian Stehr, Ludwig-Maximilians-Universität München
• Dr. med. Jochen Steinbrenner, MAS FHO, Vorsitzender Spitalleitung Spital Grabs, Ärztlicher Leiter Notfall & Ambulatorium Spital Grabs, Ärztlicher Leiter Rettungsdienst SR RWS
• Blanka Steinbrenner, Fachärztin für Pädiatrie & Neonatologie
• Dipl. Psych. Christoph J. Stengel, Psychotherapeutische Praxis, München
• Maria Steuer, Kinderärztin, Familientherapeutin, Familiennetzwerk
• Dr. Dr. Werner Stibbe, Hannover
• Gerhrad Stickel, Dipl. Informatiker (FH), Filderstadt
• Dieter Stieglitz, Diplom Psychologe/freie Praxis
• Petra Prof'in. Dr. phil. Dr. med. Stoerig, Institut für Experimentelle Psychologie, Heinrich-Heine-Universität Düsseldorf
• Dr. Jutta Stoll, LL.M., Rechtsanwältin, Frankfurt am Main
• Jürgen Stolz, Diplom-Psychologe und Psychotherapeut, Stuttgart
• Grit Stottok, Richterin am Landgericht Ansbach
• Dr. Martin Stransky, Psychologischer Psychotherapeut, Aachen
• Dr.med. Klaus Michael Strauß DEAA, Arzt für Anästhesiologie, Baden-Baden
• Dipl. Psych. Charlotte Streibl-Henning, Mannheim
• Rechtsanwalt Patrick Strösser, Hilden
• Assessor Dr. med. Martin Stübner, Arzt für Öffentliches Gesundheitswesen, Ltd. Ministerialrat a. D., München
• Dr. med. Bettina Stübner, Ärztin für Allgemeinmedizin, Gräfelfing
• Dipl.-Ing. Franz Stuhrmann
• PD Dr. med. Philipp Szavay, Leitender Oberarzt/Stellv. Physicians. Direktor, Facharzt für Kinderchirurgie, Rettungsmedizin, Intensivmedizin, Abteilung und Lehrstuhl für Kinderchirurgie, Universitätsklinikum Tübingen
• Dr. H. Peter Szutrely, FA für Urologie und Andrologie in Ruhestand, Solingen
• Dr. med. Carsten Tschechne, Internist, Weingarten
• Prof. Dr. Peter Their, Department of Cognitive Neurology, Hertie Institute of Clinical Brain Research, Tübingen
• Monika Theisen, Diplom-Psychologin, Essen
• Dipl.-biol. Martin Theiß (Doktorand Entwicklungsneurobiologie Heidelberg)
• Rechtsanwalt Rainer Thesen, Nürnberg
• Dr. med. Hans-Hartwig Thienemann, Freilassing
• Jochen Timmermann, FA für Psychosomatische Medizin, Sprecher der Sektion Psychosomatik der DGPM, Cuxhaven
• Dr.med. Wilhelm Tophinke, Arzt für Psychiatrie und Psychotherapie, Forensische Psychiatrie, (Ärztekammer HH/ DGPPN), Hamburg
• Dagmar Trees, Köln
• Prof. Dr. Vera E. Troeger, Professor of Quantitative Political Science, Department of Economics and PAIS, University of Warwick, Coventry, United Kingdom
• Rechtsanwalt Dr. André Turiaux, München
• Prof. Dr. Stefan Uhlig, Dekan der Medizinischen Fakultät der RWTH Aachen
• Dr.rer.nat Bernhard Ulrich, Bockenheim
• Dr. med. Stefan Umnus, Facharzt für Neurologie und Psychiatrie
• Dr. med. Andreas E. Urban, FECTS (Kinderchirurg, Kinderherzchirurg), ehem. Direktor des Deutschen Kinder-Herzzentrums Sankt August
• Dr. med. (Univ. Rijeka) Jana Urban-Ukic, Klinisches Institut für Psychosomatische Medizin und Psychotherapie, Düsseldorf
• Christian Utermöhlen, Arzt, Kiel
• Dr. med. Michael Veittinger, Arzt für Allgemeinmedizin, Berlin
• Dr. Friedrich Vogel, Wachenheim
• Karin Vogelpohl, Dipl.-Pädagogin, Hintergrund-Verlag Osnabrück
• Dr. rer. nat. Jens-Uwe Voss, Mitglied der Deutschen Gesellschaft für Pharmakologie und Toxikologie (DGPT), Müllheim/Baden
• Dr. Bernd Vowinkel
• Prof. Dr. rer. soc. hab. Gerhard Wagner, Fachbereich Gesellschaftswissenschaften, Goethe Universität Frankfurt am Main
• Dr. phil. Florian Wagner, Hamburg
• Doris M. Wagner, DESA, FÄ für Anästhesiologie, Kempten im Allgäu
• Barbara Wagner und Dr. med. Horst Wagner, Kinderarzt im Ruhestand, Bremen
• Dr. med. Jürgen Wagner, Arzt für Innere Medizin/ Kardiovaskulärer Präventivmediziner DGPR
• Dr. med. dent. Peter F. Walker, Giessen
• Dr. phil. Thomas Wanninger, Oldenburg
• Kurt Weber, Frauenarzt, München
• Oliver Z. Weber, Medien- und Kulturwissenschaftler, Köln
• Prof. Dr. jur. Erhard Weichhaus, Düsseldorf
• Dr. med. Stefan Weis, FA Neurologie und Psychiatrie, Neckarsulm
• Ulrich Weiskopf, Richter am Amtsgericht Butzbach ( Hessen)
• Dr. jur. Manfred Weitz, LL.M., Düsseldorf
• Rechtsanwalt J. Weitzmann, Hamburg
• Dipl. Psych. Elke Weyel, Psych. Psychotherapeutin, Neu-Isenburg
• Prof. Dr. Lars D. Wellejus, Business Administration, Decision Systems, FH Frankfurt - University of Applied Sciences
• Christian Wenig, Arzt am Bezirksklinikum Regensburg, Klinische Suchtmedizin
• Burkhard Wepner, professor of music theory and ear training (composer and conductor) at the Academy of Music and Dance Cologne (Köln HfMT), board member of the Giordano Bruno Foundation, regional group in Cologne
• Prof. Dr. Claus Werning, Frechen
• Dr. Klaus Wessel, chemists, Bad Vilbel
• Manon Weßler, psychologist, Berlin
• Dr. Dipl.-Psych. Franz Wienand, practice for child and adolescent psychiatry, psychotherapy, psychoanalysis, social psychiatry
• Dipl-Psych., Psychol psychotherapist Marlies Wildenberg, Kandel
• Dr. rer. nat. O.-H. Wilhelms
• Horst-G. Will Weber, Assessor jur., Cologne
• Dr. Christopher Wineken, internal medicine and cardiology, Zurich
• Dr. Reinhold Winkler, neurosurgeon, Munich
• Dr. phil. Ingeborg Wirries, graduate teacher, retired teacher and lecturer (1992-2010) / Leibniz Universität Hannover, Institute of Education
• Prof. Dr. Matthias Wjst, Technical University of Munich and Helmholtz Center Munich
• Dr. Bernd Woitsch, Dr. von Hauner Children's Hospital Sches, Munich
• Dr. phil. Andrea Wolf, historian, Vienna
• Dr. Ludger Wollring, ophthalmologist, Essen-Altenessen
• Tobias J. Wolters MA, doctor, emergency medicine, health promotion and prevention, occupational health center Rheine
• Dr. M. Wolters, Seelze
• Gabriele Wörn, Psychologist, Department of Child and youth, Klinikum GmbH Esslingen
• Dr. Tanja Wörner, gynecologist and Zytologin, Wetzikon, Switzerland
• Dipl.-Biol. Jann Wübbenhorst, Bleckede
• Dr. Marc-Andre Wulf, MA (phil.), a specialist in psychosomatic medicine
and Psychotherapy, LVR-Hospital Düsseldorf, Department of the Heinrich-Heine-University Düsseldorf
• Dr. Moritz worm, Center for Mind / Brain Sciences, University of Trento
• Adrian Wrzesinski (Diplom-Jurist)
• Mag Christine Wytrzens, practice for dyslexia, dyslexia
Dyscalculia, dyscalculia, Vienna
• Dipl.-Psych. Stefan Zeidler, M.Sc. / Univ. of Oregon, psychotherapist behavioral therapy, Villingen
• Prof. Dr. jur. Dr. hc Gisela Zenz. Goethe University Frankfurt am Main
• Dr. iur. Uwe Zenske, lawyer, Falkenfels
• Bernhard Zerjeski, Zuerich, Switzerland
• Lawyer Dr. Fabian Ziegenaus, LL.M., Munich
• Silvio Ziegler, Dipl.-Psych., Psychotherapist, behavioral therapist, Berlin
• Dr. Michael von Zielonka, Munich
• PD Dr. Ulrich Zimmermann, Specialist in Psychiatry and Psychotherapy, Dresden
• PhD, Bodo Zimmermann, Waibstadt
• Neithart Zimmermann, children and young doctor, Mönchengladbach
• Dr. Alexandra Zinck, Philosophy, The Hebrew University of Jerusalem
• Dipl. Psych PP gates Zuber, Furth